| Objective:To explore the clinical efficacy of electroacupuncture at scalp motor area on the recovery of wrist movement in stroke patients,and compare the differences between electroacupuncture and conventional manual stimulation in terms of the clinical efficacy and the effect on the sEMG signals of active muscles related to wrist movement,so as to optimize the clinical treatment scheme of wrist movement disorder after stroke.Methods:66 patients with wrist movement disorder due to stroke that met inclusion criteria were randomly divided into a treatment group and a control group through a randomized controlled single-blind method.The patients of both groups were given treatment in neurology and underwent acupuncture treatment for the affected area.Patients in the control group received needling on the Dingnieqianxiexian(MS 6),with retaining the needle for 30 minutes after obtaining Qi sensation.During the retention of the needles,twirling manipulation stimulation was performed twice intermittently,2 minutes each time with a frequency of 200 times/minute.Patients in the treatment group received needling on the Dingnieqianxiexian(MS 6)and connected to an electroacupuncture device after obtaining Qi sensation.A continuous wave of2 Hz was selected,and the stimulation intensity was adjusted based on the patients’ tolerance.Electroacupuncture stimulation lasted for 30 minutes.Patients in both groups were treated once a day,with six consecutive days of treatment followed by a one-day rest,which is a course of treatment,and patients received continuous treatment for 3 courses.CSS,BI(upper limb)and ROM were used to evaluate the degree of neurological deficit,activity of daily living and recovery of wrist movement before and after treatment.The sEMG signals of the affected upper limb during wrist dorsiflexion and wrist palmar flexion were collected,and the RMS was extracted to observe the state of related muscles.Efficacy was evaluated according to the clinical efficacy evaluation criteria in Chinese Scale of Clinical Neurologic Deficit.SPSS 26.0was used to process and analyze the data.Results:1.Clinical efficacy analysis:The effective rate of the treatment group was 87.50%,while the effective rate of the control group was 77.42%.The difference between the effective rates of the two groups was statistically significant(P<0.05),suggesting that the treatment group had a better therapeutic effect than the control group.2.Joint range of motion analysis:Compared with before treatment,wrist flexion angle and wrist dorsiflexion angle of the two groups were improved after treatment(P<0.001).Compared with after treatment,the treatment group showed greater improvement in wrist dorsiflexion angle compared to the control group(P<0.05).However,there was no statistically significant difference between the two groups in wrist flexion angle(P>0.05).3.BI(upper limb)score analysis:Compared with before treatment,BI(upper limb)of the two groups were improved after treatment(P<0.001).Compared with after treatment,there was no statistically significant difference between the two groups in terms of BI(upper limb)(P>0.05).4.CSS score analysis:Compared with before treatment,CSS of the two groups were improved after treatment(P<0.001).Compared with after treatment,the treatment group showed greater improvement in CSS scores compared to the control group(P<0.05).5.sEMG signals analysis:The sEMG was applied to measure the RMS values of the extensor carpi radialis longus(ECRL)and the extensor digitorum(ED)in wrist dorsiflexion,and the RMS values of the flexor carpi radialis(FCR)and the flexor carpi ulnaris(FCU)during wrist palmar flexion were detected.The results showed that the RMS values of these muscles in both groups increased significantly after treatment,as compared to before treatment(P<0.05).After comparing the two groups of patients after treatment,the differences were statistically significant(P<0.05),indicating that the recovery of wrist movement-related musclses in patients of the treatment group was superior to that in the control group.Conclusion:1.Electroacupuncture or conventional manual stimulation at the scalp motor area can improve wrist motor disorder after stroke.The clinical effect of electroacupuncture stimulation is better than that of conventional manual stimulation.2.Electroacupuncture stimulation at the scalp motor area can increase the wrist joint range of motion of patients during active movement,improve the activities of daily living of patients,and promote the neurological recovery of patients,which may be related to its efficacy in increasing the active muscles strength related to wrist motion and effectively improving muscles’ function. |
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