Simple Rehabilitation Training Research Articles

Treatment of finger spasm after stroke with wheat grain moxibustion at Shixuan (EX-UE 11) combined with rehabilitation training: a randomized controlled trial

To compare the clinical effect of wheat grain moxibustion combined with rehabilitation training and simple rehabilitation training on finger spasm after stroke. A total of 80 patients with finger spasm after stroke were randomly divided into an observation group and a control group, 40 cases in each group. The control group was given routine rehabilitation training, once a day, 30 min each time. The observation group was given wheat grain moxibustion at Shixuan (EX-UE 11) on the basis of the control group, 8~10 moxibustion cones at each point, once a day. Both groups were treated for 6 days as one course of treatment for 4 courses. The motor function of the affected hand (Fugl-Meyer assessment [FMA] score) and muscle tension (modified Ashworth scale [MAS] grading), surface EMG indexes (wrist dorsiflexor muscle and flexor carpal metacarpal muscle mean square [RMS] value), hand muscle strength (neurological deficit score [NDS]) and daily living ability (modified Barthel index [MBI] score) were compared between the two groups before and after treatment, and clinical efficacy was evaluated. After treatment, FMA and MBI scores in the 2 groups were increased compared with before treatment (P<0.05), and those in the observation group were higher than the control group (P<0.05). The RMS value of wrist dorsiflexor muscle and flexor carpal metacarpal muscle in relaxation and passive function testsand and NDS in the 2 groups were lower than those before treatment (P<0.05), and those in the observation group were lower than the control group (P<0.05). MAS grading in the 2 groups was improved compared with before treatment (P<0.05), and that in the observation group was better than the control group (P<0.05). The total effective rate of the observation group was 92.5% (37/40), which was higher than that of the control group (80.0%, 32/40, P<0.05). Wheat grain moxibustion at Shixuan (EX-UE 11) combined with rehabilitation training can improve the hand motor function and daily living ability of patients with finger spasm after stroke, improve the degree of spasm and the function of wrist dorsiflexor muscle and flexor carpal metacarpal muscle, the clinical effect is better than simple rehabilitation training.

Post-stroke shoulder-hand syndrome of phlegm-stasis obstruction treated with the combined therapy of eye acupuncture, Tengliao and rehabilitation training: a multi-central randomized controlled trial

To assess the efficacy on relieving pain and improving the range of motion of shoulder joint in post-stroke shoulder-hand syndrome of phlegm-stasis obstruction in treatment of the combined therapy of eye acupuncture, Tengliao (Chinese herbal warm dressing technique) and rehabilitation training (eye acupuncture + Tengliao + rehabilitation) as compared with the combined treatment of Tengliao and rehabilitation training (Tengliao + rehabilitation) and the simple rehabilitation training (rehabilitation). A total of 356 patients with post-stroke shoulder-hand syndrome of phlegm-stasis obstruction were randomized into an eye acupuncture + Tengliao + rehabilitation group (group A, 122 cases, 2 cases dropped off), a Tengliao + rehabilitation group (group B, 120 cases, 3 cases dropped off) and a rehabilitation group (group C, 114 cases, 1 case dropped off). In the group C, the basic treatment was combined with routine rehabilitation training. In the group B, on the base of the treatment as the group C, Tengliao was exerted. A medical bag composed of over 20 Chinese herbal materials was heated and dressed at the affected area, 30 min each time, 5 times weekly. In the group A, besides the treatment as the group B, eye acupuncture was applied to heart region, kidney region, upper jiao region and lower jiao region, 30 min each time, 5 times weekly. The treatment lasted 28 days in all of three groups. Separately, before treatment, in 7, 14, 21 and 28 days of treatment, as well as in 14 days after treatment of follow-up, the score of visual analogue scale (VAS) for pain, the score of guides to evaluation of permanent impairment (GEPI) and the score of National Institutes of Health stroke scale (NIHSS) were observed in each group. The scores of VAS, GEPI and NIHSS were all improved with the treatment lasting in the three groups (P<0.000 1). In 7, 14, 21 and 28 days of treatment and in follow-up as well, VAS scores in the group A were all lower than the group C (P<0.05). After 14 days of treatment, GEPI score showed increasing trend, while NIHSS score showed decreasing trend in the group A compared with the group B. Before treatment, GEPI score was lower and NIHSS score was higher in the group A compared with the group C (P<0.05). It was suggested that the illness was slightly serious in the group A. After propensity score matching, in 14, 21 and 28 days as well as in follow-up, GEPI scores in the group A were higher than the group C respectively (P<0.05). Regarding NIHSS score at each time point, the difference had no statistical significance between the group A and the group C (P>0.05). The combined therapy of eye acupuncture, Tengliao and rehabilitation training obtains a better efficacy on post-stroke shoulder-hand syndrome of phlegm-stasis obstruction as compared with rehabilitation training.

Impact of abdominal moxibustion in a period of day from 7 am to 9 am on improvement in post-stroke lower limb spasticity and muscle architecture parameter

To compare the therapeutic effect on post-stroke lower limb spasticity between the combined treatment of abdominal moxibustion from 7 am to 9 am and rehabilitation training and the simple rehabilitation training. A total of 100 patients with post-stroke lower limb spasticity were randomized into an observation group (50 cases, 3 cases dropped off) and a control group (50 cases, 4 cases dropped off ). In the control group, the basic treatment of internal medicine and rehabilitation training of the limbs were adopted. In the observation group, on the basis of the treatment in the control group, at the time zone from 7 am to 9 am, moxibustion on the abdomen with "eight-trigram" moxa box [the central moxa box accurately facing Shenque (CV 8)] was given, lasting for 2 h, once every two days. Both groups were treated for 6 weeks. Separately, before and after treatment, the score of Fugl-Meyer assessment of the lower extremity (FMA-LE) and the grade of modified Ashworth scale (MAS) of ankle joint were evaluated on the affected side in patients of the two groups. Muscle skeleton ultrasound (MSUS) was adopted to determine the first layer muscle thickness (MT) anterior to the tibia, the number of pennation angle (PA) and the length of muscle fibers in the medial head of gastrocnemius muscle on the affected side. Besides, after treatment, the therapeutic effect was evaluated in the two groups. After treatment, the score of FMA-LE and the grade of MAS of ankle joint on the affected side were both improved as compared with those before treatment in patients of the two groups (P<0.01, P<0.05). The improvements in the observation group were better than those in the control group (P<0.01, P<0.05). After treatment, MT anterior to the tibia, the number of PA and the length of muscle fibers in the medial head of gastrocnemius muscle on the affected side were all increased as compared with before treatment in patients of the two groups (P<0.01). The increase degree in the observation group was larger than that in the control group (P<0.01). The total effective rate was 93.6% (44/47) in the observation group, better than 80.4% (37/46) in the control group (P<0.05). The combined treatment of abdominal moxibustion from 7 am to 9 am and rehabilitation training effectively relieves post-stroke lower limb spasticity and improves the limb functions and muscle structure. The total effective rate of this combined treatment is better than that of simple rehabilitation training.

Impacts of the combined treatment of Tongdu Tiaoshen moxibustion and rehabilitation training on the motor function recovery of the upper limbs in the patients with apoplectic hemiplegia

ABSTRACT Objective: To observe the impacts of the combined treatment of Tongdu Tiaoshen moxibustion (moxibustion for promoting the circulation of the governor vessel and regulating the spirit) and rehabilitation training on the motor function recovery in the patients with apoplectic hemiplegia. Methods: A total of 50 patients with apoplectic hemiplegia and qualified in the trial recruitment criteria were divided into two groups according to random number table, 25 cases in each group. In the control group, the simple rehabilitation training was provided. In the observation group, on the base of the treatment as the control group, Tongdu Tiaoshen moxibustion was given. Main acupoints: Baihui (百会GV20), Fēngfŭ (风府GV16) and Dazhuī (大椎GV14). The treatment was given once a day, 6 treatments a week, 4 weeks as one course and two courses of treatment were required. Before and after treatment, the scores of Fugle-Meyer assessment (FMA), the modified Barthel index (MBI) and action research arm test (ARAT) were detected before and after treatment in the two groups separately. Results: After 4 and 8 weeks of treatment, the scores of FMA, MBI and ARAT were all improved obviously as compared with those before treatment respectively in patients of the two groups(all P Conclusion: The combined treatment of Tongdu Tiaoshen moxibustion and rehabilitation training promotes the recovery of the upper limb motor function and improves the self-ability of living activities in the patients with apoplectic hemiplegia. The long-term effect of this combined therapy is superior to that of simple rehabilitation training.

Effects of pricking blood therapy at meridian sinews on upper limb spasm of post-stroke patients 经筋刺血对脑卒中后患者上肢痉挛状态的影响

ObjectiveTo observe effects of pricking blood therapy at meridian sinews on upper limb spasm of post-stroke patients. MethodsA total of 72 patients with post-stroke upper limb spasm were randomly divided into a comprehensive group of pricking blood therapy at meridian sinews with rehabilitation training (comprehensive group) and the simple rehabilitation training group (rehabilitation group), and there were 36 patients in each group. On the basis of routine therapy, the patients of the two groups received rehabilitation therapy for 6 consecutive days and 1-day rest, for 4 weeks in total. On the above basis, the patients in the comprehensive group received pricking blood therapy at meridian sinews, once every other day, 3 times per week, for 4 weeks in total. Before treatment, after the first treatment, and after 4-week treatment, the patients were observed for changes of upper limb spasticity (Modified Ashworth Scale, MAS), upper limb movement function (Fugl-Meyer Assessment, FMA), activity of daily living(Modified Barthel Index, MBI), and biceps and triceps integrated electromyogram(IEMG) values were observed as well as the therapeutic effects. Results(1) After the first treatment, there were statistically significant differences of the MAS scale grades in patients of the two groups (P<0.05). The FMA scores in the comprehensive group were increased than that before treatment (P<0.05), and the MBI scores of the two groups were increased than those before treatment (both P<0.05). The FMA and MBI scores in the comprehensive group were higher than those of the rehabilitation group (both P<0.05). The biceps and triceps IEMG values were not improved than those before treatment (all P>0.05). (2) After 4-week treatment, there were statistically significant differences of MAS grades in patients of the two groups (P<0.05). The FMA and MBI scores in the two groups were increased than those before treatment (all P<0.05), and the FMA and MBI scores in the comprehensive group were higher than those in the rehabilitation group (both P<0.05). Through comparison of the differences of FMA and MBI scores of the two groups, the difference values in the comprehensive group were higher than those of the rehabilitation group (both P<0.05). The biceps and triceps IEMG values in the two groups were decreased than those before treatment (all P<0.05), and those in the comprehensive group were lower than those in the rehabilitation group (both P<0.05). The biceps and triceps IEMG values in patients of the comprehensive group were higher than those before treatment (both P<0.05). (3) After 4-week treatment, the total effective rate in the comprehensive group was 83.3% (30/36), and that was 58.3% (21/36) in the rehabilitation group. The total effective rate in the comprehensive group was higher than that in the rehabilitation group (P<0.05). ConclusionsThe pricking blood therapy at meridian sinews can release affected upper limb flexor muscle spasticity and movement function of the patients with post-stroke upper limb spasm, decrease biceps IEMG values of the affected side, and improve activities of daily living.

Clinical effect of plum-blossom needle tapping at three yin meridians of wrist on wrist joint contracture after stroke

To compare the therapeutic effect of plum-blossom needle tapping at three yin meridians of wrist combined with rehabilitation training and simple rehabilitation training on wrist joint contracture after stroke. A total of 72 patients with wrist joint contracture after stroke were randomized into an observation group and a control group, 36 cases in each one. In the control group, simple rehabilitation training was applied, 5 times a week, 3 weeks as one course and totally 3 courses were required. On the basis of the treatment in the control group, plum-blossom needle tapping at three yin meridians of wrist was adopted in the observation group. The tapping regions were wrist traveling parts of three yin meridians of hand, ranging from up 3 cun to below 1 cun of wrist crease, 3 times a week, 3 weeks as one course and totally 3 courses were required. The active range of motion (AROM) of active wrist extension, Fugl-Meyer score (FMA) and Barthel index (BI) score were observed before and after treatment in the two groups. The AROM, FMA scores and BI scores after treatment in the two groups were superior to before treatment (P<0.05), and the improvements of 3 indexes in the observation group were superior to the control group (P<0.05). The therapeutic effect of plum-blossom needle tapping at three yin meridians of wrist combined with rehabilitation training is superior to simple rehabilitation training on wrist joint contracture after stroke.

Intestinal dysfunction of spinal cord injury treated with tongdu tiaoshen moxibustion: a randomized controlled trial

To compare the clinical effect on intestinal dysfunction of spinal cord injury (SCI) between the comprehensive therapy of tongdu tiaoshen moxibustion (moxibustion for opening the governor vessel and regulating the spirit) and rehabilitation training and the simple treatment with rehabilitation training. A total of 60 patients with intestinal dysfunction of SCI were randomized into a comprehensive therapy group and a rehabilitation group, 30 cases in each one (3 cases were dropped out in each group). On the base of the routine western medicine treatment and rehabilitation training, the bowel training and rectal function training were provided, once a day in the rehabilitation group. In the comprehensive therapy group, on the base of the treatment as the rehabilitation group, the tongdu tiaoshen moxibustion was exerted at Yaoyangguan (GV 3), Mingmen (GV 4), Zhiyang (GV 9), Dazhui (GV 14) and Baihui (GV 20), etc, once a day, 30 min each time. In both groups, the treatment for 4 weeks was as one course and 3 courses of treatment were required. Separately, before treatment, after 4, 8 and 12 weeks of treatment, the scores of neurogenic bowel dysfunction (NBD) and World Health Organization quality of life scale (WHOQOL-BREF) were observed and the clinical effect was evaluated after 12 weeks of treatment. After treatment, the total effective rate was 88.9% (24/27) in the comprehensive therapy group, which was higher than 74.1% (20/27) in the rehabilitation group (P<0.05). After 4, 8 and 12 weeks of treatment, NBD scores were all reduced obviously as compared with those before treatment in the two groups (all P<0.01). After 8 and 12 weeks of treatment, NBD scores in the comprehensive therapy group were lower than the rehabilitation group (both P<0.05). After 4, 8 and 12 weeks of treatment, the scores of all of the domains (psychology, physiology, social relations and environment) in WHOQOL-BREF were higher than those before treatment in the two groups (all P<0.01). After 4 weeks of treatment, the scores in the psychology and physiology domains in the comprehensive therapy group were higher than the rehabilitation group (all P<0.05). After 8 and 12 weeks of treatment, the scores of all of the domains in the comprehensive therapy group were higher than the rehabilitation group (all P<0.05). The comprehensive treatment of tongdu tiaoshen moxibustion and rehabilitation training achieves the better effect on intestinal dysfunction of SCI than the simple rehabilitation training and greatly improves the quality of life in SCI patients.

Electroacupuncture combined with rehabilitation training improves regional cerebral blood flow and reduces infarct volume by promoting expression of angiogenesis-related factors in acute cerebral ischemia rats

To observe the effect of electroacupuncture (EA) combined with rehabilitation training on regional cerebral blood flow (rCBF) and angiogenesis in rats with acute cerebral ischemia (ACI), so as to explore its mechanisms underlying improvement of ACI. A total of 135 male SD rats were divided into 5 groups: sham-operation (sham), model, EA, rehabilitation training and EA+rehabilitation training (combined treatment) groups (n=27 rats in each group). The ACI model was established by occlusion of the middle cerebral artery with thread embolus. EA (2 Hz/20 Hz, 3-5 V) was applied to "Baihui" (GV20), "Shuigou" (GV26) and bilateral "Neiguan" (PC6) for 20 min, once daily for 14 days. The rehabilitation training including hair-brushing in an enriched environment (10 min), round wooden-stick turning (10 min), grid-board climbing (10 min), and treadmill running (30 min/d) was condacted once daily for 14 days. The rCBF was measured by Doppler ultrasound. The cerebral infarct volume (CIV) was measured after 2, 3, 5-triphenyltetrazolium chloride (TTC) staining. The expression of CD34+ in the ischemic penumbra region of brain tissue was detected by immunohistochemistry, and the expressions of angiogenesis-related factors as vascular endothelial growth factor (VEGF), vascular endothelial growth factor receptor 2 (VEGFR2) and basic fibroblast growth factor (bFGF) proteins in the ischemic brain tissue were detected by Western blot. Following modeling, the rCBF levels at the 5 min, 3rd, 7th and 14th day were significantly decreased in the model group relevant to the sham group (P<0.01). After the intervention, the rCBF levels were significantly increased on day 3, 7 and 14 in the combined treatment group and on day 7 and 14 in both the EA and rehabilitation training groups in comparison with the model group (P<0.01). The CIV was obvious in the model group in comparison with the sham group (P<0.01), but was markedly smaller in the EA, rehabilitation training and combined treatment groups on day 3,7 and 14 than in the model group (P<0.01). The number of CD34+ positive cells, and the expression levels of VEGF, VEGFR2, and bFGF proteins in ischemic brain tissues were significantly higher on day 3, 7 and 14 in the model group than in the sham group (P<0.01, P<0.05), and were further up-regulated considerably at the 3 time-points in the 3 treatment groups (P<0.01, P<0.05). The therapeutic effect of EA+rehabilitation training was significantly superior to that of simple EA and simple rehabilitation training in up-regulating rCBF, CD34+ positive cell number, and expression levels of VEGF, VEGFR2 and bFGF, and in down-regulating the CIV on day 3,7 and 14 (P<0.05, P<0.01). No significant differences were found between the EA and rehabilitation groups in the above-mentioned 6 indexes (P>0.05). EA combined with rehabilitation training can reduce the infarct volume and increase rCBF in ACI rats, which is probably associated with its effects in promoting the expression of angiogenesis-related factors of ischemic brain tissues. The effect of EA combined with rehabilitation training is markedly better than that of EA and rehabilitation training alone.

Clinical observation on plum-blossom needle combined with rehabilitation training for hand spasm after stroke

To observe the effect difference between plum-blossom needle combined with rehabilitation training and conventional rehabilitation training for hand spasm after stroke. A total of 61 patients were randomly divided into a comprehensive treatment group (30 cases) and a rehabilitation training group (31 cases). In the rehabilitation training group, Bobath occupational therapy, OT training, and hand function training were adopted, once every day; on the basis of treatment in the rehabilitation group, plum-blossom needle was applied at the lung meridian of hand-taiyin, heart meridian of hand-shaoyin, pericardium meridian of hand-jueyin in the comprehensive treatment group. The treatment was given once every two days, three weeks as one course in the two gnoups. After 3 courses of treatment, clinical efficacy evaluation was performed, and the modified Ashworth scale and Fugl-Meyer (FMA) motor function scores were assessed before and after treatment. After treatment, the grade for Ashworth scale and FMA scores in the comprehensive treatment group and the rehabilitation trainning group were better than those before treatment (all P<0.05), and the improvements in hand spasm and hand fuction in the comprehensive treatment group were superior apparently to those in the rehabilitation trainning group (both P<0.05) The total effective rate of hand function was 93.3% (28/30) in the comprehensive treatment group, which was better than 74.2% (23/31) in the rehabilitation training group (P<0.05). Plum-blossom needle combined with rehabilitation training are more effective than simple rehabilitation training for hand spasm after stroke.

Clinical research for rehabilitation training combined with modified shu-acupuncture for joint dysfunction after meniscal suture surgery

To compare the effects on joint dysfunction after meniscal suture surgery between rehabilitation training combined with modified shu-acupuncture and simple rehabilitation training. Seventy-one patients with meniscal suture surgery were randomized into an observation group (n=36) and a control group (n=35). Patients in the observation group received modified shu-acupuncture combined with rehabilitation training. Acupuncture for 8 weeks were at Zutonggu (BL 65), Shugu (BL 66), Neiting (ST 44), Xiangu (ST 43), Xiaxi (GB 43), Zulinqi (GB 41), Dadu (SP 2), Taibai (SP 3), Xingjian (LR 2), and Taichong (LR 3), once a day for continuous 6 days with 1 day for rest. Patients in the control group received simple rehabilitation training for continuous 8 weeks. The training included quadriceps femoris, range of knee joint motion and motion and limb walking on the affected side. The effect score for meniscus injury after treatment from Japanese Orthopaedics Association (JOA) and visual analogue scale (VAS) score were recorded before and after treatment. The effects were compared in the two groups. After treatment, the VAS and JOA scores were improved in the two groups (all P<0.05), with better results in the observation group (both P<0.05). The effective rate was 91.7% (33/36) in the observation group, which was better than 80.0% (28/35) in the control group (P<0.05). Rehabilitation training combined with shu-acupuncture achieve better effect than simple rehabilitation training for joint dysfunction after meniscal suture surgery.

Acupuncture combined with rehabilitation training for the limb spasm after stroke

To observe the different clinical effects on the limb spasm after stroke among acupuncture mainly at governor vessel (GV) and Jiaji (EX-B 2) combined with rehabilitation training, simple acupuncture and simple rehabilitation training. Ninety patients according to admission sequence were randomized into a combination group, an acupuncture group and a rehabilitation group, 30 cases in each one. The comprehensive treatment was applied in the combination group. The same acupuncture was used in the acupuncture group; the same rehabilitation was used in the rehabilitation group. All the treatment was given for 4 courses with 1 d between the two courses, 10 times as one course, once a day. The modified Ashworth score (MAS), clinic spasticity index (CSI), Fugl-Meyer assessment (FMA), Barthel index (BI) were observed before and after treatment. The effects were compared among the three groups. After treatment, the MAS, CSI score of the three groups significantly decreased in comparison with those before treatment (all P<0.05), the FMA and BI score of the three groups increased in comparison with those before treatment (all P<0.05). The improvements for MAS, CSI, FMA and BI of the combination group were better than those of the acupuncture group and the rehabilitation group (all P<0.05). There were no statistical significance between the acupuncture group and the rehabilitation group (all P>0.05). The total effective rate of 90.0% (27/30) in the combination group was better than 76.7% (23/30) in the acupuncture group and 73.3% (22/30) in the rehabilitation group (both P<0.05). Acupuncture mainly at GV and Jiaji (EX-B 2) combined with rehabilitation training are superior to simple acupuncture and simple rehabilitation training on reducing muscle tonus for stroke patients with limb spasm, which can more effectively improve the ability of daily life and motor function.

Influence of cluster needling at scalp acupoints combined with rehabilitation training on balance functions of children with cerebral palsy

ObjectiveTo observe therapeutic effects of scalp acupuncture at close acupoints combined with rehabilitation training on balance functions of children with cerebral palsy (CP). MethodsSixty children with CP were randomly divided into a scalp acupuncture combined with rehabilitation training group (group SA+RT) and a rehabilitation training group (group RT) with 30 cases in each group. Conventional rehabilitation therapy and balance training were applied in group RT, and scalp acupuncture at close acupoints in the parietal region and sub-occipital region was added besides rehabilitation training in group SA+RT. Balance functions were evaluated by using Berg rating scale, and abilities of daily living were estimated by using rating scale for activities of daily living (ADL). ResultsAfter treatment, both Berg scores for balance and ADL scores were significantly improved in both groups (all P<0.05), and the improvement in group SA+RT was more obvious than that in group RT (both P<0.05). ConclusionCombination of scalp acupuncture at close acupoints with rehabilitation training is superior to simple rehabilitation training in improving balance functions and activities of daily living in children with cerebral palsy.