The Effect Of Acupuncture On The Immediate Effect Of Co-activation Mode Of Elbow Extension After Stroke

Objective:To investigate the effect of single acupuncture on hemiplegia quchi and waiguan points in stroke patients with hemiplegia(Brunnstrom III~IV and modified Ashworth ?2).Methods:This study is divided into two parts.Part I: to define the muscle contraction mode and force control of hemiplegic upper limb under the flexor co-activation mode in stroke patients.This section included qualified stroke patients(n=24)and matched healthy subjects(n=24).Subjects in the two groups used isokinetic muscle strength training apparatus to measure the joint moment value when the maximum isokinetic extension exercise of the elbow joint and shoulder joint abduction was 75° and forward flexion was 40°.The Coefficient of Variation(CV)and the co-synergy ratio(CR)of the muscle groups associated with the flexor co-activation mode(pectoralis major,anterior middle and posterior bands of deltoid,triceps brachii,biceps brachialis,brachioradialis brachialis)were detected by surface electromyography in the exercise of isokinetic elbow extension at 15°/s,30°/s and 45°/s,respectively.Results data processing and statistical analysis were performed.Part ii: the stroke patients included in the first part(n=24)were randomly divided into the acupuncture group and the control group,with 12 patients in each group.Quchi and waiguan points were taken.The acupuncture group was given conventional acupuncture on the affected side,and the control group was given pseudo-needle stimulation on the affected side.The first and third items of the Wolf motor function test(WMFT)were used to assess the upper limb motor function of patients in the two groups,and the joint moment value,CV and CR of patients in the two groups were detected by the same method as in the first part.Results data processing and statistical analysis were performed.Results:1.Results of upper limb muscle contraction pattern and force control in hemiplegic patients with stroke under flexor co-activation mode.(1)in terms of joint torque,the results showed that the value of joint torque in the stroke patients group was smaller than that in the healthy subjects group,and the difference was statistically significant(P?0.05);(2)in terms of CV,compared with healthy subjects,at 15°/s,30°/s and 45°/s,the CV of stroke patients group increased,and the differences between the two groups were statistically significant(P?0.05);The CV of the stroke patients group was in positive proportion to the increase of the speed,which increased with the increase of the speed,and the difference was statistically significant(P?0.05);(3)CR,15 ° / 45 °,30 ° / s and s/s three speeds elbow uniform stretching,patients with cerebral apoplexy group of upper limb flexor muscle activation patterns related total muscle group compared with healthy subjects group of the same muscle group CR,the result shows: the group of patients with cerebral apoplexy pectoralis major,biceps,gong radial muscle increased CR compared with healthy subjects group,difference has statistical significance(P?0.05).2.The effect of acupuncture at quchi and waiguan points on the co-activation mode of upper limb flexors under the extension exercise of elbow joint after stroke.(1)in terms of WMFT,compared with the control group and before intervention,WMFT scores in the acupuncture group were improved,and the differences were statistically significant(P?0.05);(2)in terms of joint torque,compared with the control group and before intervention,the value of joint torque in the acupuncture group was increased,and the differences were statistically significant(P?0.05);(3)in terms of CV,when the elbow joint was extended at 15°/s and 30°/s,compared with the control group before intervention and the control group,the CV in the acupuncture group was reduced,and the differences were statistically significant(P?0.05),45°/s elbow joint extension exercise,acupuncture group and control group CV comparison,the results showed that: after acupuncture intervention,the two groups of joint CV changes were not statistically significant(P?0.05);(4)in terms of CR,when the elbow joint was extended at 15°/s,30°/s and 45°/s,CR of the muscle groups related to the co-activation mode of upper limb flexor muscles was compared between the two groups after acupuncture intervention.The results showed that CR of the pectoralis major,biceps brachii and brachioralis in the acupuncture group was reduced compared with that before intervention and the control group,and the differences were statistically significant(P?0.05).Conclusions:1.Compared with healthy subjects,patients with stroke showed decreased joint strength and reduced motor control ability during elbow extension exercise;In patients with stroke,abnormal co-activation of the pectoralis major,biceps brachialis and brachioradialis increased during elbow extension.2.In patients with a single needling stroke(Brunnstrom III~IV and modified Ashworth?2),the affected side curvature and waiguan point can improve the coactivation mode of flexor muscles during elbow extension of hemiplegic upper limb within a short time window and enhance the motor control ability of hemiplegic upper limb.