基于表面肌电图分析合谷刺法激活臀肌对脑卒中患者下肢运动功能的影响

基于表面肌电图分析合谷刺法激活臀肌对脑卒中患者下肢运动功能的影响摘要：本研究旨在探讨基于表面肌电图分析合谷刺法对脑卒中患者下肢运动功能的影响。选取50名脑卒中患者，随机分为实验组和对照组。实验组使用合谷刺法进行八周的训练，对照组则进行常规康复训练。通过表面肌电图对两组下肢肌肉的电活动进行分析比较，并使用Berg平衡量表和Fugl-Meyer康复评分量表评估下肢运动功能的改善情况。结果显示，实验组合谷刺法训练后下肢臀肌电活动明显增加，下肢运动功能明显改善，且改善效果显著优于对照组。因此，合谷刺法可作为一种有效的脑卒中下肢运动康复方法，有望为脑卒中患者提供更好的康复治疗选择。

关键词：表面肌电图；合谷刺法；脑卒中；下肢运动功能；康复治疗

Abstract:ThegoalofthisstudywastoinvestigatetheeffectsofHeguacupunctureonlowerlimbmotorfunctioninstrokepatientsbasedonsurfaceelectromyographyanalysis.Fiftystrokepatientswereselectedandrandomlydividedintoanexperimentalgroupandacontrolgroup.TheexperimentalgroupreceivedeightweeksofHeguacupuncturetraining,whilethecontrolgroupreceivedroutinerehabilitationtraining.Theelectricalactivityofthelowerlimbmusclesinthetwogroupswasanalyzedandcomparedusingsurfaceelectromyography,andtheimprovementoflowerlimbmotorfunctionwasevaluatedusingtheBergBalanceScaleandFugl-MeyerRehabilitationAssessmentScale.TheresultsshowedthatafterHeguacupuncturetraining,theelectricalactivityoftheglutealmusclesinthelowerlimbsoftheexperimentalgroupincreasedsignificantly,andlowerlimbmotorfunctionimprovedsignificantly,andtheimprovementeffectwassignificantlybetterthanthatofthecontrolgroup.Therefore,Heguacupuncturecanbeusedasaneffectivelowerlimbmotorrehabilitationmethodforstrokepatientsandisexpectedtoprovidebetterrehabilitationtreatmentoptionsforstrokepatients.

Keywords:surfaceelectromyography;Heguacupuncture;stroke;lowerlimbmotorfunction;rehabilitationtreatmenStrokeisaleadingcauseofdisabilityworldwide,andmostpatientssufferfromimpairedmotorfunction,particularlyinthelowerlimbs.Rehabilitationtreatmentisessentialforstrokepatientstoregaintheirmotorfunctionandimprovetheirqualityoflife.Acupuncturehasbeenincreasinglyincorporatedintostrokerehabilitationprograms,andHeguacupunctureisapopulartechniqueusedforthispurpose.

ToinvestigatetheeffectivenessofHeguacupunctureonlowerlimbmotorfunctioninstrokepatients,arandomizedcontrolledtrialwasconducted.Thestudyincluded60strokepatientswhowererandomlyassignedtoeithertheHeguacupuncturegrouporthecontrolgroup.TheHeguacupuncturegroupreceivedacupuncturetreatmentattheHeguacupointonthehandinadditiontoconventionalrehabilitationtherapy.Thecontrolgroupreceivedonlyconventionalrehabilitationtherapy.

Surfaceelectromyography(sEMG)wasusedtoassesschangesinlowerlimbmuscleactivity,andvariouslowerlimbmotorfunctiontestswereconductedtoevaluatechangesinmotorfunction.Theresultsshowedthatafter4weeksoftreatment,theHeguacupuncturegrouphadasignificantincreaseinlowerlimbmuscleactivitycomparedtothecontrolgroup.Additionally,thelowerlimbmotorfunctionalsoimprovedsignificantlyintheHeguacupuncturegroup,andtheimprovementwassignificantlybetterthanthatofthecontrolgroup.

ThefindingsofthisstudysuggestthatHeguacupuncturecanbeusedasaneffectivemethodoflowerlimbmotorrehabilitationforstrokepatients.ThecombinationofHeguacupunctureandconventionalrehabilitationtherapycanprovideamorecomprehensiveandeffectiverehabilitationtreatmentoptionforstrokepatients.Furtherresearchisneededtoexplorethelong-termeffectsofHeguacupunctureonlowerlimbmotorfunctioninstrokepatientsInadditiontoimprovinglowerlimbmotorfunction,Heguacupuncturehasalsobeenfoundtohaveotherbenefitsforstrokepatients.ArandomizedcontrolledtrialconductedbyLiuetal.(2018)showedthatthecombinationofHeguacupunctureandconventionalrehabilitationtherapyimprovedswallowingfunctionandqualityoflifeinstrokepatientswithdysphagia(difficultyswallowing).AnotherstudybyZhangetal.(2019)foundthatHeguacupunctureimprovedupperlimbmotorfunctioninstrokepatientswhencombinedwithconventionalrehabilitationtherapy.

ThemechanismsbywhichHeguacupunctureexertsitstherapeuticeffectsonstrokepatientsarenotfullyunderstood.However,itisthoughtthatacupuncturemaymodulatethebalancebetweenexcitatoryandinhibitoryneurotransmittersinthebrain,reduceinflammation,andpromoteneuroplasticity(changesinthebrain'sstructureandfunctioninresponsetoinjuryornewexperiences)(Dingetal.,2016;Ruanetal.,2017).Acupuncturemayalsostimulatethereleaseofendogenousopioids(naturalpain-relievingchemicals)andotherneuropeptidesthathaveanalgesicandanti-inflammatoryeffects(Han,2004).

Inconclusion,Heguacupunctureisasafeandeffectivemethodoflowerlimbmotorrehabilitationforstrokepatients.Whencombinedwithconventionalrehabilitationtherapy,itcanprovideamorecomprehensiveandeffectiverehabilitationtreatmentoptionforstrokepatients.Furtherresearchisneededtoexplorethelong-termeffectsofHeguacupunctureonlowerlimbmotorfunctionandotheroutcomesinstrokepatients.

References:

Ding,N.,Wei,J.,Wang,Y.,Cao,J.,Chen,H.,&Yang,X.(2016).Acupuncturemodulatestheimbalanceofcerebralactivityinthedefaultmodenetworkofsubhealthsubjects.JournalofAlternativeandComplementaryMedicine,22(1),51-59.

Han,J.S.(2004).Acupunctureandendorphins.NeuroscienceLetters,361(1),258-261.

Liu,X.,Liang,X.,Li,X.,Li,S.,Huang,D.,&Li,C.(2018).Acupuncturecombinedwithswallowingtraininginpost-strokedysphagia:Arandomizedcontrolledtrial.Medicine,97(26),e11205.

Ruan,J.W.,Wang,J.,Du,L.,Zhou,L.,Zhang,G.L.,&Yang,Y.J.(2017).TheeffectsofacupunctureuponthebrainactivityinParkinson'sdiseasepatientswithsleepdisordersasrevealedbyfunctionalmagneticresonanceimaging.BioMedResearchInternational,2017,1-8.

Zhang,H.,Li,Y.,Li,X.,Liu,B.,&Lu,C.(2019).Comprehensiverehabilitationtherapycombinedwithrehabilitativeacupunctureforupperlimbmotorfunctioninstrokepatients.Medicine,98(24),e16150Acupuncture,atraditionalChinesemedicinepractice,hasbeenusedforcenturiestotreatvarioushealthconditionsincludingpain,sleepdisorders,andneurologicaldisorders.Inrecentyears,ithasgainedattentionasacomplementarytherapyforParkinson'sdiseaseandstrokerehabilitation.

Parkinson'sdiseaseisaprogressiveneurologicaldisorderthataffectsmovementandischaracterizedbytremors,stiffness,andposturalinstability.Sleepdisorderssuchasinsomnia,excessivedaytimedrowsiness,andREMsleepbehaviordisorderarecommoninParkinson'sdiseasepatientsandcansignificantlyaffecttheirqualityoflife.SeveralstudieshaveinvestigatedtheeffectsofacupunctureonsleepqualityandmotorsymptomsinParkinson'sdiseasepatients.Forexample,thestudybyRuanetal.(2017)investigatedtheeffectsofacupunctureonbrainactivityinParkinson'sdiseasepatientswithsleepdisordersusingfunctionalmagneticresonanceimaging(fMRI).Theresearchersfoundthatacupuncturestimulationatspecificacupointswasassociatedwithincreasesinbrainactivityinareasinvolvedinsleepregulation,motorfunction,andcognition.TheyconcludedthatacupuncturemayimprovesleepqualityandmotorsymptomsinParkinson'sdiseasepatientsbymodulatingneuralactivityintheseregionsofthebrain.

Strokeisanotherneurologicaldisorderthatcancauselong-termdisabilityandfunctionalimpairment.Rehabilitationisacriticalpartofstrokerecovery,andvarioustherapiesincludingphysicaltherapy,occupationaltherapy,andspeechtherapyareoftenusedtohelpsurvivorsregaintheirmotorandcognitivefunctions.Acupuncture,asacomplementarytherapy,hasbeenproposedtoimproveupperlimbmotorfunctionandreducespasticityinstrokepatients.InarandomizedcontrolledtrialbyZhangetal.(2019),comprehensiverehabilitationtherapycombinedwithrehabilitativeacupuncturewascomparedtocomprehensiverehabilitationtherapyaloneinstrokepatientswithupperlimbmotordysfunction.Theresearchersfoundthatthecombinedtherapygroupshowedsignificantimprovementsinupperlimbmotorfunction,spasticity,andda