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<p><b>OBJECTIVE</b>To observe the impacts on post-stroke unilateral spatial neglect treated with acupuncture for "regaining consciousness, benefiting marrow and opening orifices" and rehabilitation.</p><p><b>METHODS</b>Forty patients of post-stroke unilateral spatial neglect were randomized into an observation group and a control group, 20 cases in each one. In the observation group, acupuncture was applied to the acupoints for "regaining consciousness, benefiting marrow and opening orifices", named Baihui (GV 20), Sishencong (EX-HN 1), Benshen (GB 13), Shenting (GV 24), and the bilateral-primary points and-connecting points of the heart meridian, pericardium meridian and kidney meridian, as well as the acupoints along the affected meridians. Additionally, the rehabilitation was provided. In the control group, acupuncture at the acupoints along the affected meridians and rehabilitation were adopted. The treatment was given once a day, 5 times a week. After 8 weeks of treatment the evaluation was made. the indexes of unilateral spatial neglect such as line bisection test, the score of the mini-mental state examination (MMSE), the score of simple Fugl-Meyer motor function assessment and the modified Barthel indexes were adopted for the assessment of the severity of unilateral spatial neglect, cognitive function, motor function, and the activities of daily living.</p><p><b>RESULTS</b>After treatment, the indexes of unilateral spatial neglect (line bisection test, line cancellation test, clock-drawing test and copying drawing test), MMSE score, the simple Fugl-Meyer motor function assessment and modified Barthel indexes were all improved as compared with those before treatment in the two groups (all<0.01). The improvements in the observation group were more obvious than those in the control group (<0.05,<0.01).</p><p><b>CONCLUSION</b>The combination of acupuncture treatment for "regaining consciousness, benefiting marrow and opening orifices" and rehabilitation much more effectively alleviates the severity of post-stroke unilateral spatial neglect and improves the motor function and the activities of daily living in the patients.</p>
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Objective To probe the therapeutic effect of ginger-salt-partitioned moxibustion on urge incontinence after stroke. Methods 40 stroke patients following urge incontinence were randomly divided into control group (n=20) and experimental group (n=20). 2 groups all received the same treatment, routine acupuncture and rehabilitation. Additionally, the experimental group received ginger-salt-partitioned moxibustion at Shenque (CV8). The curative effect was compared after treatment (4 weeks). Results 36 cases finished the treatment, 17 in the control group and 19 in the experimental group. Total number of urination, urinary incontinence and nocturia reduced, and the average volume of each urine increased (P0.05). Conclusion The effect of ginger-salt-partitioned moxibustion at Shenque on poststroke following urination disorders is remarkable.
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@#Objective To investigate the effects of electroacupuncture on head Shen- acupoints on cognitive dysfunction after stroke. Methods 35 cases with cognitive dysfunction after stroke were divided into treatment group (n=19) and control group (n=16). The control group received conventional treatment, while the treatment group received electroacupuncture on Sishencong (EX-HN1), Shenting (GV24) and Benshen (GB13) in addition. They were assessed with Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) before and after 4-week treatment. Results The scores of MMSE and MoCA increased more in the treatment group than in the control group (P<0.05). The scores of visuospatial abilities and executive functions, attention and concentration, calculation, memory and orientation of MoCA improved more in the treatment group than in the control group (P<0.05). Conclusion Electroacupuncture on head Shen-acupoints can improve cognitive function in patients after stroke.
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@#Objective To probe the therapeutic effect of ginger-salt-partitioned moxibustion on urge incontinence after stroke. Methods 40 stroke patients following urge incontinence were randomly divided into control group (n=20) and experimental group (n=20). 2 groups all received the same treatment, routine acupuncture and rehabilitation. Additionally, the experimental group received ginger-salt-partitioned moxibustion at Shenque (CV8). The curative effect was compared after treatment (4 weeks). Results 36 cases finished the treatment, 17 in the control group and 19 in the experimental group. Total number of urination, urinary incontinence and nocturia reduced, and the average volume of each urine increased (P<0.05), and volume of bladder residual urine reduced in 2 groups after treatment (P<0.001), while the experimental group was better than the control group (P<0.05). The scores of modified Barthel Index increased in 2 groups after treatment, but there was no significant difference between 2 groups (P>0.05). Conclusion The effect of ginger-salt-partitioned moxibustion at Shenque on poststroke following urination disorders is remarkable.
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Objective To investigate the effects of electroacupuncture on head Shen-acupoints on cognitive dysfunction after stroke. Methods 35 cases with cognitive dysfunction after stroke were divided into treatment group (n=19) and control group (n=16). The control group received conventional treatment, while the treatment group received electroacupuncture on Sishencong (EX-HN1), Shenting (GV24) and Benshen (GB13) in addition. They were assessed with Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) before and after 4-week treatment. Results The scores of MMSE and MoCA increased more in the treatment group than in the con-trol group (P<0.05). The scores of visuospatial abilities and executive functions, attention and concentration, calculation, memory and orien-tation of MoCA improved more in the treatment group than in the control group (P<0.05). Conclusion Electroacupuncture on head Shen-acupoints can improve cognitive function in patients after stroke.
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Objective To investigate the trend of length of stay (LOS) and identify variables that predict LOS for inpatient rehabilitation after stroke. Methods A total of 3049 inpatients who completed the stroke rehabilitation program at Beijing Bo'ai Hospital from January 2002 to December 2011 were reviewed and analyzed with nonparametric rank sum test and binary Logistic regression analysis. Results The median of LOS was 82 days, and tended to decrease obviously in 2010 and 2011. On Logistic regression analysis, there were 13 variables as-sociated with LOS, in which operation, muscle spasm, gain of activities of daily living (ADL), onset admission interval, nosocomial infec-tion, complications, speech disorder, the type of stroke, the number of hospitalization, methods of payment were the risk factors, and age, functional ambulation classificateion and Fugl-Meyer Assessment were protect factors. Conclusion Reducing LOS must base on rehabilita-tion efficacy, and the improvement of hospital management process, the prevention of complications and nosocomial infection control, and early rehabilitation intervention can reduce the LOS.
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@#Objective To observe the effect of electroacupuncture on basic fibroblast growth factor (bFGF), Desmin and extracellular signal-regulated kinase (ERK1/2) expression of rabbits with acute lumbar muscle contusion, and discuss the possible mechanism of muscle tissue regeneration and repair. Methods 40 male New Zealand rabbits were randomly divided into blank group (BG, n=10), model group (MG, n=10), Weizhong (BL40) electroacupuncture group (WG, n=10) and local electroacupuncture group (LG, n=10). Lumbar muscle injury was established with blunt trauma, and the rabbits were assessed with Appearance Score. The WG and LG accepted electroacupuncture for 2 weeks after modeling. The lumbar muscle of each animal was stained with HE to observe pathological changes, and immunohistochemical staining was used to observe bFGF expression, and Western blotting was used to detect the expression of Desmin and ERK1/2 protein.Results Appearance Score was more in the MG, WG and LG than in the BG (P<0.01). Histological score ranked from more to less as MG,LG, WG and BG (P<0.05). The expression of bFGF ranked as LG, WG, MG and BG (P<0.01), Desmin ranked as WG=LG and BG=MG (P<0.05), ERK1/2 as LG=WG, MG and BG (P<0.05). Conclusion Electroacupuncture could promote the regeneration and repair of tissue after acute lumbar muscle contusion, which may be related to the up-regulation of bFGF/ERK signaling pathway.
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@#Objective To study the effects of body weight support treadmill training (BWSTT) or Du channel electroacupuncture (DcEA) on locomotion function and expressions of nerve growth factor (NGF) and growth-associated protein-43 (GAP-43) in rats with spinal cord transection. Methods 54 adult SD rats were divided into control group (n=18), BWSTT group (n=18) and DcEA group (n=18). Each group was divided into 3 subgroups (n=6) for 8 d, 15 d and 30 d respectively. Spinal cord transection was performed at T10 level. The locomotion function was assessed with Bosso-Beattie-Bresnahan locomotor rating scale for open field (BBB scale) and the expressions of NGF and GAP-43 in spinal cord tissues to the injury caudal ends were measured with immunohistochemistry. Results The scores of BBB scales and expressions of NGF and GAP-43 were higher in BWSTT group and DcEA group than those in the control group on the 8th d,15th d and 30th d respectively (P<0.01); and were higher in DcEA group than in BWSTT group on the 15th d and 30th d respectively (P<0.01). Conclusion Both BWSTT and DcEA can improve the locomotion function in rats with spinal cord transection and increase expressions of NGF and GAP-43 in spinal cord tissues, and DcEA is more effective.
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Objective To study the effect of swallowing training combined with acupuncture on patients with dysphagia more than one month after stroke or traumatic brain injury (TBI). Methods 61 patients with dysphagia meeting the inclusion criteria were randomly divided into a control group (31 cases) and a treatment group (30 cases). Both groups were subdivided according to the course of disease-1 ～ 2 months or ＞ 2 months. The patients in the control group received only swallowing training, 30 min per day, 5 times a week for 9 weeks. The patients in the treatment group were treated with the same swallowing training as the control group, additionally combined with acupuncture at the acupoints around the neck, including Lianquan (Ren23), Jinjin (EX-HN12), Yuye (EX-HNI3),Fengchi (GB20) , Yifeng (SJ17) and Wangu (GB12). Acupuncture was performed 5 times a week, 30 min per session for 8-week courses with a week's break between them. Results Both groups and their sub-groups demonstrated statistically and clinically significant improvements in swallowing function. Scores in the 2 treatment subgroups showed more improvement than in the control group. There was, however, no significant difference between the 2 treated subgroups in either their post-treatment or pre-treatment swallowing function scores. The cure rate in the treatment group was significantly higher than in the control group, but there was no significant difference in the total effectiveness rate between the two groups. Conclusion Swallowing training alone or combined with acupuncture can improve the swallowing of patients with chronic neurogenic dysphagia. The combination therapy was more effective. The improvement was not related with the course of the disease.
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@#Objective To identify the risk factors for osteoporosis in patients with hemiplegia. Methods The total body bone mineral density (BMD) of 366 patients with hemiplegia in the stage of rehabilitation was measured with dual-energy X-ray absorptiometry. The data of the patients were analyzed with multiple logistic regressions. Results The incidence of osteoporosis was 15.3 % (56/366) in the cohort. ≥60 years old (OR=5.434, 95% CI:2.734～10.801), duration of disease (OR=1.046, 95% CI:1.013～1.080), body mass index (BMI) (OR=0.746,95% CI:0.622～0.840),ADL level (OR=0.618, 95% CI: 0.444～0.858) were independently correlated with osteoporosis in patients with hemiplegia. Conclusion Patients with hemiplegia in the stage of rehabilitation were at a high risk of osteoporosis. Aged over 60 years old, lower BMI, longer duration of disease and ADL level were independent risk factors for osteoporosis, which called for supervision and prophylaxis on osteoporosis.
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@#Objective To investigate the changes of bone mineral density (BMD) and bone mass and the influencing factors in patients with hemiplegia.Methods The total BMD, bone mass, lean mass and fat mass of 366 patients (313 stroke cases and 53 TBI cases) with hemiplegia were tested by dual-energy X-ray absorptiometry, as well as the clinical features of all patients, were studied.Results The bone masses in the paretic side (upper limb, lower limb and trunk) decreased significantly compared with nonparetic side ( P<0.01); the differences of bone masses (%) in upper limb, lower limb and trunk between paretic and nonparetic side decreased with duration of disease or trauma ( P<0.01). The multivariable stepwise regression analyses showed that the total bone mass and total BMD were negatively correlated with age and duration of disease significantly (all P<0.01), and positively correlated with body mass index (BMI) significantly ( P<0.01), the total BMD was also positively correlated with lean mass ( P<0.01) and ADL level ( P<0.05).Conclusion The bone mass deceases in the paretic side significantly, and gets worse with the duration of disease. Age, duration of disease or trauma and BMI influence total BMD and bone mass; in addition, total BMD is correlated with total lean mass and ADL level.
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@#Objective To observe the changes of functional magnetic resonance imaging(fMRI) when performing transcutaneous electrical nerve stimulation(TENS) in Du Channel of the patient with brain trauma.Methods TENS was applied to the acupoints of Mingmen and Yaoyangguan in a patient with brain trauma.The changes of brain function when TENS performed were observed with fMRI.Results Compared with rest status,multiple brain areas were activated during stimulation.Conclusion TENS in Du Channel may influence neural plasticity course after brain injury.
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Objective To explore fMRI data with independent component analysis (ICA) in order to investigate effects of transcutaneous electrical acupoint stimulation (TEAS) on brain function. Methods The experiment was performed on a whole-body 1.5 T GE Signa Excite MRI scanner with which the brain oxygenation level dependent (BOLD)/EPI images were acquired from a female traumatic brain injury patient. A block designed protocol was used. Both durations of rest and TEAS were 30 seconds. The data processing was performed with GIFT, Statistical Parametric Mapping 5 (SPM5) and MRIcro. Results from ICA and SPM were compared. Results Extended Infomax algorithm provided by GIFT found thirteen independent components (ICs), each of which contained a spatial map and a corresponding time course. The spatial maps associated with task-related ICs resembled the activation maps from SPM5 but were not totally identical. In addition, the time courses of these ICs differed from the shape of canonical HRF model used by SPM. Conclusion ICA is a good choice to investigate data and obtain prior knowledge before using model-based methods such as SPM.