| Purpose:Application with Rehabilitation therapy with Eye-acupuncture for rehabilitation in patients with spasm stage of stroke.Make various clinical curative effect evaluation respectively from the recovery degree of traditional Chinese medicine syndrome,degree of nerve function defect degree,limb spasm,motor function,balance function,ability of activities of daily life,and used the biomechanical evaluation by isokinetic muscle strength test.At the same time,explore the relationship between the retention time of Eye-acupuncture and the curative effect of rehabilitation,so as to standardize the application of Rehabilitation therapy with Eye-acupuncture in spasm stage of stroke.Material and Method: 120 patients with cerebral infarction or cerebral hemorrhage in spasm stage who met the requirements were selected from the second department of encephalopathy rehabilitation in the rehabilitation center of liaoning university of traditional Chinese medicine.They were randomly divided into 4 groups: Eye-acupuncture control group,Rehabilitation with Eye-acupuncture group 1,Rehabilitation with Eye-acupuncture group 2 and Rehabilitation control group,with 30 patients in each group.There was no significant difference in gender,age,course of disease,type of stroke and degree of dysfunction among the patients in each group.Patients in the Eye-acupuncture control group were treated with conventional Eye-acupuncture.The acupuncture was started after 0.5 hours of acupuncture,followed by rehabilitation treatment.The patients in the Rehabilitation with Eye-acupuncture group 1 were given the Rehabilitation therapy with Eye-acupuncture,and the needles were retained for 4 hours.Patients in the Rehabilitation with Eye-acupuncture group 2 were given the Rehabilitation therapy with Eye-acupuncture,and the needles were retained for 8 hours.Patients in the Rehabilitation control group received only routine rehabilitation treatment.The items of rehabilitation treatment include exercise therapy,joint loosening training,occupational therapy,intermediate frequency electrotherapy and MOTOmed lower limb exercise training.The frequency of the above treatment is 1 time a day,5 times a week,and the course of treatment is 4 weeks,with a total of 20 times of treatment.Rehabilitation therapy with Eye-acupuncture was performed by the same physicians and therapists,and the time and intensity of rehabilitation treatment were not different in each group.Before enrollment,the patients' cognitive function was evaluated with the Mini-mental state examination scale(MMSE),and the patients with severe cognitive impairment were excluded.The rehabilitation evaluation was conducted one time before and one time after treatment,and the TCM syndrome score was used to evaluate the TCM syndrome changes of the patients.The degree of neurological impairment of the patients was evaluated by the national institutes of health stroke scale(NIHSS)score.The clinical spasm index(CSI)and modified Ashworth scale(MAS)were used to evaluate the spasm degree of lower limbs.The lower limb motor function of the patient was assessed by fugl-meyer assessment(FMA).Berg balance scale(BBS)was used to evaluate the balance function of patients.Barthel index(BI)was used to assess the patients' ability of activities of daily life.At the same time,biomechanical indexes were used to assess the peak moment(PT)and active range of motion(AROM)of flexor myogroups during flexor and extension of the affected side knee joint.After the completion of each rehabilitation assessment,the results were recorded objectively and accurately,and the data were statistically analyzed using SPSS23.0 software.Results: 1.Statistical results of general information of patients showed that there was no significant difference in gender,age,type of stroke,and course of disease in each group(P > 0.05),suggesting comparability.There was no significant difference in MMSE scores between the four groups(P > 0.05),suggesting comparability.2.In terms of TCM syndrome score,there was no significant difference between each group before treatment(P > 0.05),and the difference was significant after treatment(P < 0.01).After treatment,the comparison of TCM syndrome scores between groups showed that the Eye-acupuncture control group,Rehabilitation with Eye-acupuncture group 1 and Rehabilitation with Eye-acupuncture group 2 were all lower than the Rehabilitation control group(P < 0.05),and there was no significant difference between the Rehabilitation with Eye-acupuncture group 1 and Rehabilitation with Eye-acupuncture group 2(P > 0.05),which were all lower than the Eye-acupuncture control group(P < 0.05).Comparison of the difference of TCM syndrome score between groups before and after treatment showed that the difference between Rehabilitation with Eye-acupuncture groups 1,2 and Eye-acupuncture control group was greater than that of the Rehabilitation control group(P < 0.01),and there was no significant difference between Rehabilitation with Eye-acupuncture groups 1 and 2(P > 0.05),which was greater than that of Eye-acupuncture control group(P < 0.01).3.In terms of NIHSS score,there was no significant difference in each group before treatment(P > 0.05),and the difference was significant after treatment(P < 0.01).After treatment,the comparison of NIHSS scores between groups showed that the Eye-acupuncture control group,the Rehabilitation with Eye-acupuncture group 1 and group 2 were all lower than the Rehabilitation control group(P < 0.01),and there was no significant difference between the Rehabilitation with Eye-acupuncture group 1 and group 2(P > 0.05),which were all lower than the Eye-acupuncture control group(P < 0.01).Comparison of NIHSS score difference between groups before and after treatment showed that the difference of NIHSS score in the Eye-acupuncture control group,Rehabilitation with Eye-acupuncture group 1 and group 2 was greater than that in the Rehabilitation control group(P < 0.01),and there was no significant difference between the Rehabilitation with Eye-acupuncture group 1 and group 2(P > 0.05),which was greater than that in the Eye-acupuncture control group(P < 0.05).4.In terms of the modified Ashworth scale(MAS),there was no significant difference between each group before treatment(P > 0.05),and the difference was significant after treatment(P < 0.01).After treatment,the comparison of MAS evaluation between groups showed that the Eye-acupuncture control group,Rehabilitation with Eye-acupuncture group 1 and group 2 were all lower than the Rehabilitation control group(P < 0.01),Rehabilitation with Eye-acupuncture group 1 and group 2(P > 0.05),which were all lower than the Eye-acupuncture control group(P < 0.01).Comparison of the difference of MAS scores before and after treatment showed that the Rehabilitation with Eye-acupuncture group 1 and group 2 and Eye-acupuncture control group were all greater than the Rehabilitation control group(P < 0.01),and there was no significant difference between the Rehabilitation with Eye-acupuncture group 1 and group 2(P > 0.05),which were all greater than the Eye-acupuncture control group(P < 0.01).5.In terms of clinical spasmus index(CSI)score,there was no significant difference between each group before treatment(P > 0.05),and the difference was significant(P < 0.01).Comparison of CSI scores between groups after treatment showed that the Rehabilitation control group was higher than the other three groups,with a significant difference(P < 0.01).There was no significant difference between the Rehabilitation with Eye-acupuncture group 1 and group 2(P > 0.05),which was lower than that of the Eye-acupuncture control group.Comparison of the difference of CSI score between groups before and after treatment showed that the Rehabilitation control group was lower than the other three groups,with a significant difference(P < 0.01).There was no significant difference between the Rehabilitation with Eye-acupuncture group 1 and group 2(P > 0.05),which was higher than that of the Eye-acupuncture control group(P < 0.01).6.In terms of lower limb motor function score assessed by fugl-meyer(FMA),there was no significant difference between each group before treatment(P > 0.05),and the difference was significant after treatment(P < 0.01).Comparison of FMA lower limb motor function score between groups after treatment showed that Eye-acupuncture control group,Rehabilitation with Eye-acupuncture group 1 and group 2 were all larger than the Rehabilitation control group,with significant differences(P < 0.01).There was no significant difference between Rehabilitation with Eye-acupuncture group 1(P > 0.05)and group 2(P < 0.01).Comparison of the difference of FMA lower limb motor function score before and after treatment showed that the difference of FMA lower limb motor function score in the Eye-acupuncture control group,Rehabilitation with Eye-acupuncture group 1 and group 2 was greater than that in the Rehabilitation control group,with significant difference(P < 0.01).There was no significant difference between the Rehabilitation with Eye-acupuncture group 1 and group 2(P > 0.05),which was higher than that of the Eye-acupuncture control group(P < 0.05).7.In terms of Berg balance scale(BBS)score,there was no significant difference among the three groups before treatment(P > 0.05),and the difference was significantly after treatment than before treatment(P < 0.01).After treatment,the comparison of BBS scores between groups showed that the Eye-acupuncture control group,the Rehabilitation with Eye-acupuncture group 1 and group 2 were all larger than the Rehabilitation control group,with significant differences(P < 0.05).There was no significant difference between Rehabilitation with Eye-acupuncture group 1(P > 0.05)and group 2(P < 0.01).The comparison of the difference of BBS scores between groups before and after treatment showed that the difference was greater in the Eye-acupuncture control group,the Rehabilitation with Eye-acupuncture group 1 and group 2 than in the Rehabilitation control group(P < 0.05).There was no significant difference between the Rehabilitation with Eye-acupuncture group 1(P > 0.05)and group 2(P < 0.01).8.In terms of Barthel index(BI),there was no significant difference between each group before treatment(P > 0.05),and the difference was significantly higher after treatment than before treatment(P < 0.01).Comparison of post-treatment BI scores between groups showed that the Eye-acupuncture control group,Rehabilitation with Eye-acupuncture group 1 and group 2 were all higher than the Rehabilitation control group,with significant differences(P < 0.05).There was no significant difference in BI score between the Rehabilitation with Eye-acupuncture group 2 and group 1(P > 0.05),which was higher than that of the Eye-acupuncture control group(P < 0.01).Comparing the difference of BI score before and after treatment,the difference of Eye-acupuncture control group,Rehabilitation with Eye-acupuncture group 1 and group 2 was greater than that of the Rehabilitation control group(P < 0.05).There was no significant difference between the Rehabilitation with Eye-acupuncture group 1(P > 0.05)and group 2(P < 0.01).9.In terms of isokinetic muscle strength test,there was no significant difference in PT value and AROM in each group before treatment(P > 0.05),and the PT value and AROM after treatment were significantly higher than before treatment,with significant difference(P < 0.01).Comparison of PT value and AROM between groups after treatment showed that the Eye-acupuncture control group,Rehabilitation with Eye-acupuncture group 1 and Rehabilitation with Eye-acupuncture group 2 were all higher than the Rehabilitation control group,with significant differences(P < 0.05).There was no significant difference between the Rehabilitation with Eye-acupuncture group 1(P > 0.05)and group 2(P < 0.05).Comparison of PT and AROM differences before and after treatment in each group showed that the difference of PT and AROM in the Eye-acupuncture control group,Rehabilitation with Eye-acupuncture group 1 and group 2 was greater than that in the Rehabilitation control group(P < 0.01).There was no significant difference between the Rehabilitation with Eye-acupuncture group 1(P > 0.05)and group 2(P < 0.01).Conclusion: 1.The Rehabilitation therapy with Eye-acupuncture can effectively improve the TCM syndrome of wind-phlegm blocking collateral during the spasm stage of apoplexy;2.The Rehabilitation therapy with Eye-acupuncture can significantly improve the degree of neurological impairment in patients of stroke during the spasm stage;3.The Rehabilitation therapy with Eye-acupuncture can effectively relieve the spasm degree of lower limb in patients of stroke during the spasm stage,and improve the motor function of the affected lower limb,balance function and ability of activity of daily life;4.The Rehabilitation therapy with Eye-acupuncture can significantly improve the active movement ability of knee flexor in patients of stroke during the spasm stage and increase the range of motion of the joint;5.In terms of improving spasm of lower limb,improving motor function,range of motion,balance function and activity of daily life,the curative effect of Rehabilitation therapy with Eye-acupuncture is obviously better than that of conventional rehabilitation therapy and combined therapy with eye acupuncture and rehabilitation,and the curative effect of Rehabilitation therapy with Eye-acupuncture is similar to that of recovery with eye needle retaining for 8 hours and 4 hours. |
PDF Full Text Request