| Background:Stroke has become a leading cause of disability and the second most common cause of death,which amounts to a huge combined burden worldwide.In China,there are more than seven million stroke survivors.Approximately,70%of them are experiencing functional disabilities.Hemiplegia is the most significant symptom.People suffering from hemiplegia face a variety of challenges in regaining independence in daily activities,which not only requires long-term recovery but also increases the burden on the family and society as a whole.Other than the comprehensive rehabilitation techniques,acupuncture is used widely in clinical settings and recommended by the World Health Organization as an alternative and complementary therapy.Many clinical studies about acupuncture for post-stroke hemiplegia have been conducted in the past decades.Intradermal needle can be inserted perpendicularly into the skin with a tiny needle and be fixed with a piece of adhesive tape for 1 to 5 days,during which time the patients can move freely without any discomfort.In previous work,patients' motor function and life ability were assessed by scales,which lacks objectivity because the score depends on the researchers partly.The RSSCAN gait system can provide biomechanical parameters such as step speed,step length,step stride,support time,swing time,among others.Objective:To explore the potential effect and biomechanical mechanisms of intradermal needle for post-stroke hemiplegia recovery,as well as to provide a basis for future larger clinical studies.Methods:The patients according to inclusive criteria of Dongzhimen Hospital were recruited and then invited to participate in this study.The eligible participants were randomly allocated into two groups by a 1:1 ratio using a randomization procedure.All patients received conventional rehabilitation therapy.On top of basic treatment,the experimental group received authentic intradermal needling,whereas the control group received sham intradermal needling.All therapeutic methods were taken once a day,5 days per week.After 4 weeks of treatment,we evaluated the effects and prognosis by biomechanical indexes from RSSCAN gait system and clinical scales.Results:54 participants were included,among which 10 participants excluded due to not completing the treatment cycle.All statistical analysis subjects were 44 participants who satisfied the Per Protocol Set.Baseline condition of demographic information,data from RSSCAN gait system and clinical scales had no statistical differences between two groups(P>0.05).After treatment,step speed got significantly improved in both groups(P<0.05).Patients in treatment group had quicker speed than control group(P<0.05).The total time of the control group was significantly improved(P<0.05).The support time,swing time and total time were not significantly improved(P>0.05).The step length and stride of both group,step width of control group were significantly improved(P<0.05).The step length improvement of treatment group was more significant than that of control group(P<0.05).There was no significant difference between the two groups in step stride(P>0.05).The NIHSS,FMA-lower limb,BBS,BI,SS-QOL,and HAMD scales of the two groups were significantly improved compared with those before treatment(P<0.05).There was significant difference between the treatment group and the control group(P<0.05).Correlation analysis was performed within all patients of PPS group.The data of baseline were analyzed.There was a significant positive correlation between step speed and FMA-lower limb scale scores(P<0.05).Step length had significantly negative correlation with NIHSS(P<0.05)and had significantly positive correlation with FAM-lower limb and BBS(P<0.05).The step stride was significantly positively correlated with FAM-lower limb and BBS(P<0.05).There was significantly negative correlation between step width and BBS.(P<0.05).Overall,the support time of patients' paralyzed side was significantly shorter than the nonparalyzed side(P<0.05).The swing time of paralyzed side was significantly longer than the nonparalyzed side(P<0.05).There was no statistically significant difference of total time,step length,step stride and stride width between both sides(P>0.05).The peak forces of nonparalyzed side in the area of M1 and H2 were significantly higher than the paralyzed side(P<0.05).Other areas had no significant difference(P>0.05).Conclusion:The results reflect the satisfying effectiveness of the rehabilitation training method for post-stroke hemiplegia and the greater effectiveness of intradermal needle therapy to treat post-stroke hemiplegia.Gait information was significantly correlated with the clinical scale,confirming the feasibility and effectiveness of gait assessment for functional assessment of patients with hemiplegia after stroke.By comparing the gait indicators of the paralyzed side and the nonparalyzed side,it is suggested that patients with hemiplegia may be more dependent on the nonparalyzed side when walking.No adverse events occurred in all patients,confirming the safety of basic rehabilitation and intradermal needle. |
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