The effect of rehabilitation training combined with acupressure therapy on wrist dorsiflexion function in patients with subacute stroke
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摘要:
目的 亚急性期脑卒中患者存在腕背伸功能及上肢运动功能障碍，常规内科护理联合康复训练的疗效仍有提升空间，本研究应用康复训练结合揿针疗法，分析其对亚急性期脑卒中患者腕背伸功能的影响。 方法 选取2023年1月—2024年12月绍兴市中医院收治的182例亚急性期脑卒中患者，根据随机数字表法将其分为对照组(91例)和观察组(91例)。对照组给予内科常规护理和康复训练，观察组在对照组基础上给予揿针疗法。比较2组患者临床疗效、腕屈肌表面肌电图(sEMG)、腕背伸功能及上肢运动功能。 结果 观察组治疗总有效率为93.4%(85/91)，高于对照组[82.4%(75/91)，P＜0.05]；治疗后，观察组患侧腕屈肌积分肌电值(iEMG)及均方根值(RMS)分别为(58.76±10.61)μV、(32.76±7.13)μV，均高于对照组[(54.29±13.74)μV、(24.81±6.60)μV，P＜0.05]；治疗后，观察组腕关节被动活动度(PROM)及简式Fugl-Meyer运动功能量表(FMA)得分分别为(11.83±3.56)°、(17.13±4.35)分，均高于对照组[(8.02±2.18)°、(14.29±4.68)分，P＜0.05]。 结论 揿针疗法在改善亚急性期脑卒中患者腕背伸功能、上肢运动功能方面优于单一的康复训练，可促进患者功能恢复。 Abstract:Objective Patients suffering from subacute stroke have been shown to exhibit impaired wrist extension function and upper limb motor dysfunction. There is still room for improvement in the efficacy of conventional internal medicine nursing combined with rehabilitation training. This study applied a combination of rehabilitation training and acupressure therapy to analyze its impact on wrist extension function in patients with subacute stroke. Methods Convenience sampling was employed to select 182 patients with subacute stroke admitted to Shaoxing Traditional Chinese Medicine Hospital from January 2023 to December 2024, as the subjects of the research. Participants were randomly allocated into two experimental cohorts using a randomized numerical table approach, with each cohort comprising of 91 subjects. The control group received routine internal medicine nursing and rehabilitation training, while the observation group received acupuncture therapy based on the control group. A comparison was to be made of the clinical efficacy in two groups of patients, with reference to surface electromyography (sEMG) of wrist flexors, wrist dorsiflexion function, and upper limb motor function, both before and after treatment. Results The total effective rate of the observation group was found to be 93.4% (85/91), which was higher than that of the control group [82.4% (75/91), P < 0.05]; Following the administration of treatment, the integrated electromyography (iEMG) and root mean square (RMS) values of the affected wrist flexor muscle in the observation group were found to be (58.76±10.61) μV and (32.76±7.13) μV, which were found to be higher than those in the control group (54.29±13.74) μV and (24.81±6.60) μV, P < 0.05; Following the administration of treatment, the passive range of motion (PROM) and the simplified Fugl-Meyer assessment scale (FMA) scores of the observation group were found to be (11.83±3.56)° and (17.13±4.35) points, respectively, which were higher than those of the control group (8.02±2.18)° and (14.29±4.68) points, P < 0.05. Conclusion Acupressure therapy has been demonstrated to be more efficacious than conventional rehabilitation training in restoring wrist extension function and upper limb motor function in patients with subacute stroke, and can promote functional recovery in these patients. -
Key words:
- Stroke /
- Subacute phase /
- Acupuncture therapy /
- Wrist dorsiflexion function
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表 1 2组亚急性期脑卒中患者一般资料比较
Table 1. Comparison of general data of two groups of patients with subacute stroke
项目 对照组(n=91) 观察组(n=91) 统计量 P值 性别(例) 男性 38 34 0.368a 0.544 女性 53 57 年龄(x±s，岁) 63.78±7.21 62.86±8.43 0.791b 0.430 病程(x±s，d) 41.76±8.59 42.13±9.02 0.283b 0.777 偏瘫侧(例) 左 44 40 0.354a 0.552 右 47 51 卒中类型(例) 脑梗死 56 59 0.213a 0.645 脑出血 35 32 注：a为χ2值，b为t值。 
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表 2 2组亚急性期脑卒中患者治疗前后腕屈肌表面肌电图比较(x±s，μV)
Table 2. Comparison of surface electromyography of flexor carpi muscles before and after treatment in two groups of patients with subacute stroke(x±s, μV)
组别 例数 iEMG RMS 治疗前 治疗后 治疗前 治疗后 对照组 91 41.18±10.25 54.29±13.74b 18.52±5.19 24.81±6.60b 观察组 91 40.62±9.83 58.76±10.61b 18.73±5.54 32.76±7.13b 统计量 0.376a 2.314c 0.264a 7.038c P值 0.707 0.017 0.792 ＜0.001 注：a为t值，c为F值；与同组干预前比较，bP < 0.05。
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表 3 2组亚急性期脑卒中患者治疗前后腕背伸功能及运动功能比较(x±s)
Table 3. Comparison of wrist dorsiflexion function and motor function before and after treatment in two groups of patients with subacute stroke(x±s)
组别 例数 PROM(°) FMA量表(分) 治疗前 治疗后 治疗前 治疗后 对照组 91 1.24±0.40 8.02±2.18b 9.03±2.73 14.29±4.68b 观察组 91 1.27±0.52 11.83±3.56b 8.82±2.59 17.13±4.35b 统计量 0.436a 7.470c 0.532a 3.599c P值 0.663 ＜0.001 0.595 ＜0.001 注：a为t值，c为F值；与同组干预前比较，bP < 0.05。
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