ABSTRACT
Objective:To apply multimodal ultrasound imaging in spasticity assessment for stroke patients with hemiplegia. Methods:From March to September, 2019, 44 inpatients with lower limb spastic hemiplegia after stroke (patients) and 46 healthy volunteers (controls) were scanned with two-dimensional ultrasound imaging, shear wave elastography and super microvascular imaging at the same area of gastrocnemius muscle of both sides of patients and right side of controls, in resting and maximum isometric contraction. The parameters of shear wave velocity (SWV), blood flow signal, pinnation angle (PA), fascicle length (FL) and muscle thickness (MT) were recorded. Results:SWV increased in the affected side of the patients compared with those of the unaffected side and controls in resting (t > 6.346, P < 0.01), while FL shortened (|t| > 6.235, P < 0.01), MT and PA changed compared with those of the unaffected side (|t| > 2.198, P < 0.05), and blood flow signal decreased compared with those of the controls (t = 2.604, P < 0.05). In maximum isometric contraction, the decrease of FL was less compared with those of the unaffected side and controls (Z > 6.703, P < 0.001). Conclusion:Ultrasound imaging can quantitatively evaluate spasticity of gastrocnemius muscle for patients with stroke in terms of morphological structure, blood flow, and muscle stiffness.
ABSTRACT
Objective: To evaluate the clinical efficacy of the Governor Vessel-unblocking and mind-regulating acupuncture method plus repetitive transcranial magnetic stimulation (rTMS) in the treatment of post-stroke insomnia. Methods: A total of 72 patients with post-stroke insomnia were randomly divided into 2 groups, with 36 cases in each group. The control group received rTMS treatment with a frequency of 1 Hz and a motion threshold value of 90％. The observation group received acupuncture with Governor Vessel-unblocking and mind-regulating method based on the rTMS treatment of the control group. The points were Baihui (GV 20), Shenting (GV 24), Yintang (GV 29), Fengfu (GV 16), Sishencong (EX-HN 1), Shenmen (HT 7), Sanyinjiao (SP 6), Shenmai (BL 62) and Zhaohai (KI 6). The treatment was performed once a day for 5 d a week followed by 2 d of rest for 4 weeks. The improvements of Pittsburgh sleep quality index (PSQI), self-rating anxiety scale (SAS) and self-rating depression scale (SDS) scores were observed after treatment, and the clinical efficacy was compared between the two groups. Results: After 4 weeks of treatment, the PSQI, SAS, and SDS scores of the two groups were all reduced, and the intra-group differences were statistically significant (all P<0.001). After treatment, the three scores in the observation group were all lower than those in the control group, and the differences between the two groups were statistically significant (P<0.05, P<0.05, P<0.001). There was a statistically significant difference between the observation group and the control group comparing the clinical efficacy (P<0.05). Conclusion: The therapeutic effect of the Governor Vessel-unblocking and mind-regulating acupuncture method plus rTMS in treating post-stroke insomnia is better than rTMS alone, and it can better improve the anxiety and depression of patients.