Objective: To explore the effect of dynamic scalp acupuncture combined with task-oriented mirror therapy (TOMT) for upper limb motor function and activity ability of daily living in patients with hemiplegia after ischemic stroke.
Methods: Seventy-eight patients with hemiplegia after ischemic stroke were randomly divided into a dynamic scalp acupuncture group, a TOMT group, and a scalp acupuncture group, 26 cases in each group (1 case dropped off in the TOMT group and the scalp acupuncture group respectively). All three groups received routine rehabilitation training and medication treatment. The TOMT group was treated with TOMT for 40 min a day, 5 days a week for 8 weeks. The scalp acupuncture group was treated with TOMT after the scalp acupuncture, and the dynamic scalp acupuncture group was treated with TOMT during the scalp acupuncture treatment. The scalp acupuncture treatment was applied at ipsilateral up 1/5 and mid 2/5 of Dingnie Qianxiexian and Dingnie Houxiexian, and the needles were retained for 40 min. The scalp acupuncture treatment was given once a day, 5 days a week for 8 weeks. Before treatment and after 4 weeks and 8 weeks of treatment, the functions of upper limb and hand were evaluated by simplified Fugl-Meyer assessment (FMA) scale upper limb part and functional test for the hemiplegic upper extremity-Hong Kong version (FTHUE-HK) grade, the muscle tension of the upper extremity flexor elbow muscle group was assessed by modified Ashworth scale (MAS) and the activity ability of daily living was assessed by modified Barthel index (MBI).
Results: After 4 weeks and 8 weeks of treatment, the FMA scores, FTHUE-HK grades and MBI scores in the three groups were better than those before treatment (P<0.01, P<0.05), and MAS scores after 4 weeks of treatment in the three groups were better than those before treatment (P<0.05). After 4 weeks and 8 weeks of treatment, the FMA scores, FTHUE-HK grades and MBI scores in the dynamic scalp acupuncture group were better than those in the TOMT group and the scalp acupuncture group (P<0.05), and these items in the scalp acupuncture group were better than those in the TOMT group (P<0.05).
Conclusion: The dynamic scalp acupuncture combined with TOMT treatment can effectively improve the upper limb function and the activities ability of daily living in patients with hemiplegia after ischemic stroke, which is better than TOMT after scalp acupuncture and simple TOMT treatment.
目的：探讨互动式头针结合任务导向性镜像疗法（TOMT）对缺血性脑卒中偏瘫患者上肢运动功能及日常生活活动能力的影响。方法：将78例患者随机分为互动式头针组、镜像组和头针组，每组26例（镜像组及头针组各脱落1例）。3组患者均接受药物治疗及常规康复训练。镜像组接受TOMT治疗，每天40 min，每周5 d，连续治疗8周。头针组在头针结束后进行TOMT治疗，互动式头针组在头针留针期间同时进行TOMT治疗，两组取穴均为病灶同侧顶颞前斜线上1/5、中2/5及顶颞后斜线上1/5、中2/5，留针40 min，每日1次，每周5 d，连续治疗8周。分别于治疗前和治疗4、8周后采用简化Fugl-Meyer量表（FMA）上肢运动功能部分评分、偏瘫上肢功能测试-香港版（FTHUE-HK）分级评定各组患者上肢功能和手功能；改良Ashworth量表（MAS）评定各组患者上肢屈肘肌群肌张力；改良Barthel指数（MBI）评定各组患者日常生活活动能力。结果：3组患者治疗4、8周后FMA评分、FTHUE-HK分级和MBI评分均优于治疗前（P<0.01，P<0.05），治疗4周后MAS评分高于治疗前（P<0.05）。治疗4周、8周后互动式头针组患者FMA评分、FTHUE-HK分级和MBI评分均优于镜像组和头针组（P<0.05），头针组均优于镜像组（P<0.05）。结论：互动式头针结合TOMT治疗可有效改善缺血性脑卒中偏瘫患者上肢运动功能，提高其日常生活活动能力，疗效优于头针后TOMT治疗和单纯TOMT治疗。.
Keywords: dynamic scalp acupuncture; hemiplegia; ischemic stroke; task-oriented mirror therapy(TOMT); upper limb function.