The Clinical Research Of Triple Acupuncture Therapy On Knee Joint Motor Control In Strokes

Objective:To evaluate objectively the flexion-extension function of the knee joint for stroke Patients by analyzing the sEMG signals, we improved the existing needling methods, observed the effect on the control ability of the knee joint function, and verified its mechanism through the sEMG system.Methods:Aiming at evaluating the motor function of the muscle of the leg objectively,40patients suffered from stroke and40healthy volunteers matched with age and sex were studied, collected the sEMG signals of the vastus lateralis、vastus medialis、rectus femoris and biceps femoris,extracted RMS and CR.In reference to evidence-based medicine standards,40cases of patients were designed into two groups:control group and the treatment group. The control group was given conventional acupuncture, the body acupoints are as follow:、 biguan、futu、xuehai、fengshi、yinmen、weiyang,body acupuncture needles were left and given flexor and extensor alternation of functional electrical stimulation. The stimulation of body acupuncture was to the degree of patient tolerance while the body acupuncture was to the degree of muscular contraction clearly; The control group was combined the triple needling with flexor and extensor alternation of functional electrical stimulation, the body acupoints are as follow:bigua、futu、fengshi、xuehai、yinmen、weiyang. Two groups were also given by the cluster needling of scalp point with Ding Qu and Dingqian Qu of Yu’s Scalp Acupuncture with filiform needles; Scalp acupuncture needles were powered up30minutes, then were left6hours,twisting once to two times per30minutes for each treatment and treat for six times per week. The sEMG-characteristic value extracted was comparatively studied between the unaffected side and the affected side of patients and healthy control group. The clinical effect of each group was evaluated by the sEMG、MMT、Fulg-Meyer assessment of motor function、 ADL Barthel index scale、CSI and CSS by a professional responsible for evaluating the scroes.Results:Firstly,During the extension and flexion of knee joint,compared with the left side knee joint of the healthy control group, both sides of quadriceps femoris and biceps femoris of the hemiplegic patients with stroke’s RMS values decreased (P<0.001), greater than the unaffected side(P<0.001). Secondly, during the extension of knee joint, the affected side of the muscle of the leg patients with stroke’s RMS values were less than the healthy control group(P<0.001),greater than the unaffected side(P<0.001);and the RMS values of the vastus medialis and biceps femoris on the unaffected side were less than the healthy control group, but no significant deviation was found.(P>0.05);Thirdly,during the flexion of knee joint, the CR values of the affected side were greater than the unaffected and healthy control group, which had significant difference(P<0.05);the CR values of the affected side were less than the healthy group,which showed no significance(P>0.05);The CR values of the affected side were better than the affected side and the healthy control group,which showed significant deviation (P<0.05).Finally, the differentials were compared btween the two groups selecting the RMS、CR、 the Fugl-Meyer scores、Scale Barthel ADL scores、MMT、CSI and the CSS value scores,the treatment group was better than the control group, which had significant difference(P<0.001or0.05). Moreover, the total clinical curative rate was90%, obviously higher than the control group.Conclusion:1、During the extension postion,the contractility decreased on the vastus lateralis、vastus medialis、rectus femoris and biceps femoris of the two sides in stroke patients,and the affacted side decreased significantly.2、There was mild spasticity in the extensor of the patients’affected sides. The anteroposterior leg muscles in strokepatients lose norlnal co—contraction pattern.3、Electric triple needling acupuncture therapy can induce normal movement patterns,letdown the muscle tone,improve the contraction ability and coordination among the muscles,which can inhance the control capability of knee joint.4、Both two treatments can improve motor function and activity of daily living.The clinical effect of the treatment group was superior to the control group.