Clinical Effect Of Proprioceptive Training Combined With Electroacupuncture On Cervical Spondylosis Of Cervical Type

Research background:Cervical spondylosis,also known as cervical syndrome(CS),refers to a series of clinical symptoms and signs caused by degenerative changes of cervical intervertebral disc and its secondary cervical histopathological changes involving cervical nerve root,spinal cord,vertebral artery and sympathetic nerve.It is the general name of cervical osteoarthritis,proliferative cervical spondylitis,cervical nerve root syndrome and cervical disc prolapse.Clinically,cervical spondylosis can be divided into four types: cervical spondylosis of cervical type,cervical spondylotic radiculopathy,cervical spondylotic myelopathy and other types.The incidence rate of cervical spondylosis is 40% in these 4 types of cervical spondylosis.With the popularity of mobile phones,computers and other multimedia devices,there are more and more "bow heads" and "scientific neck".Cervical spondylosis has become a common disease in today’s era.Patients with cervical spondylosis suffer from the torture of diseases.Neck back pain,upper limb weakness,finger numbness,lower limb weakness,walking difficulty,dizziness,nausea,vomiting and even blurred vision are common symptoms of cervical spondylosis.Therefore,exploring rehabilitation treatment methods to treat and improve the condition and functional state of patients with cervical spondylosis has become a research hotspot over the years.There are many pathogenic factors of cervical spondylosis,including cervical degenerative changes,impaired proprioceptive function,chronic strain,improper posture,congenital malformation of cervical spine and so on.The current study found that patients with cervical spondylosis have proprioceptive disorder.The maintenance of balance depends on the joint maintenance of proprioception,vision and vestibular perception.Some studies have shown that the impairment of proprioception in the neck can affect the dynamic and static balance function of the human body.Cervical spondylosis is a high-frequency disease of acupuncture and moxibustion.Acupuncture and moxibustion has a significant effect on cervical spondylosis and is deeply welcomed by the broad masses of the people.Electroacupuncture is a method of treatment with micro low-frequency pulse current,which is developed on the basis of acupuncture and moxibustion.On the basis of acupuncture and moxibustion,combined with low-frequency pulse current,it can accelerate the elimination of local inflammatory factors and relieve patients’ pain and other clinical symptoms faster.Patients with cervical spondylosis often have symptoms of neck pain.If the pain is serious,it may lead to serious limitation of the range of motion of the neck.If patients are given proprioceptive training at this time,it may aggravate pain symptoms,resulting in psychological and physiological resistance,affecting the therapeutic effect of proprioceptive training and reducing patients’ compliance.Acupuncture and moxibustion is effective in relieving pain.Proprioceptive training based on acupuncture and moxibustion alleviating muscle spasm and pain can improve the efficacy of proprioceptive training.The two methods are combined and complement each other,so as to promote the recovery of patients with cervical spondylosis.Therefore,in-depth study of proprioceptive training combined with electroacupuncture on the clinical efficacy of cervical spondylosis has important scientific significance and clinical application value.Purpose of the experiment:1.The purpose of this study is to explore the rehabilitation treatment effect of proprioceptive training combined with electroacupuncture on cervical spondylosis,so as to provide theoretical basis and guidance for the evaluation and treatment of cervical spondylosis.2.Using proprioceptive indexes to evaluate the clinical efficacy of traditional Chinese acupuncture and moxibustion in the treatment of cervical spondylosis,explore the application of acupuncture and moxibustion in improving proprioceptive function of patients with cervical spondylosis,and provide basic theoretical support and support for acupuncture and moxibustion in improving proprioceptive function.Experimental method:In this study,subjects were recruited in the rehabilitation department of Tianjin People’s Hospital in strict accordance with the inclusion criteria and exclusion criteria.90 patients with cervical spondylosis were randomly divided into three groups.The experimental group(30 cases)received proprioceptive training combined with electroacupuncture at Cervical Jiaji point;Control group 1(30 cases)was treated with electroacupuncture at Cervical Jiaji point;Control group 2(30 cases)received proprioceptive training.All patients were treated for 1 month.Five times a week for 4weeks.Before and after treatment,the subjects of the three groups need to evaluate the clinical recovery effect of cervical spondylosis by cervical dysfunction index NDI questionnaire,Mc Gill Pain Questionnaire MPQ score,Berg balance scale,proprioceptive function,balance function and neck surface electromyography signal.Experimental results:1.In this study,patients were recruited and treated in the rehabilitation department of Tianjin People’s Hospital in strict accordance with the inclusion criteria,exclusion criteria and abscission criteria.The experimental group(30 cases)received proprioception combined with electroacupuncture at Cervical Jiaji point,the control group 1(30 cases)received electroacupuncture at Cervical Jiaji point,and the control group 2(30 cases)received proprioception training.In the course of treatment,2people in the experimental group withdrew from the experiment due to the epidemic situation,1 person in the control group withdrew from the experiment due to work and treatment,and 2 people in the control group withdrew from the experiment due to physical discomfort.Therefore,85 people remained in the experiment.There were 28 patients in the experimental group,including 17 males and 11 females.The average condition was 3.66 ± 3.41 months;The average age was 50.03 ± 5.81 years;The average height was 167.86±7.46 cm;The average body weight was 64.03±9.53 kg;There were 29 patients in control group 1,including 17 males and 12 females.The average condition was 4.55±3.93 months;The average age was 51.55±7.47 years;The average height was 170.72±7.62 cm;The average body weight was 69.27±9.55 kg.In the control group 2,there were 28 people,16 men and 12 women.The average condition was 4.00±3.08 months;The average age was 51.86±6.60 years;The average height was 170.28±6.22 cm;The average body weight was 66.32±11.77 kg.The data and data of all patients who did not fall off were counted.There was no significant difference in the general data of patients(P > 0.05).2.After 4 weeks of rehabilitation treatment,the NDI scores of the three groups were significantly lower than those before treatment(P<0.05)。The changes of NDI scores before and after treatment in proprioceptive training group were(42.93±6.17,16.14±4.58,P < 0.05),before and after treatment in electroacupuncture group were(43.03 ± 6.34,20.34 ± 4.25,P < 0.05),and before and after rehabilitation in proprioceptive training combined with electroacupuncture group were(41.71±6.75,12.93 ± 4.20,P < 0.05).The decrease of NDI score indicates that the cervical dysfunction of the three groups has been reduced and improved,and the decrease degree of the combined treatment group is more significant than that of proprioception training group and electroacupuncture treatment group(P < 0.05).3.After 4 weeks of rehabilitation treatment,the MPQ scores of the three groups were significantly lower than those before treatment(P < 0.05).The changes of PPI scores of existing pain intensity before and after treatment in proprioception training group were(3.96±0.79,1.18±0.48,P < 0.05),those in electroacupuncture treatment group were(4.00±0.65,1.21±0.62,P < 0.05),and those in proprioception training combined with electroacupuncture treatment group were(4.18±0.94,0.50±0.57,P< 0.05).The changes of PRI scores of pain grading index before and after treatment in proprioception training group were(7.46 ± 0.74,2.57 ± 0.88,P < 0.05),those in electroacupuncture treatment group were(7.28±0.96,2.10±0.67,P < 0.05),and those in proprioception training combined with electroacupuncture treatment group were(6.75±1.21,0.89±0.57,P < 0.05).The changes of VAS Score in proprioception training group before and after treatment were(5.39 ± 0.87,1.39 ± 0.69,P < 0.05),that in electroacupuncture treatment group before and after treatment were(5.38±1.01,1.62±0.87,P < 0.05),and that in proprioception training combined with electroacupuncture treatment group before and after rehabilitation treatment were(5.00±0.82,0.61±0.57,P < 0.05).The scores of PPI,PRI and vas decreased,indicating that the pain of patients was improved and alleviated,and the degree of decline in the combined treatment group was more significant than that in the proprioceptive training group and electroacupuncture treatment group(P < 0.05).4.After 4 weeks of rehabilitation treatment,the Berg scores of the three groups were significantly higher than those before treatment(P < 0.05).The changes of Berg scores before and after treatment in proprioceptive training group were(47.21±2.73,52.58±1.49,P < 0.05),before and after treatment in electroacupuncture group were(47.31 ± 1.93,51.97 ± 1.68,P < 0.05),and before and after rehabilitation in proprioceptive training combined with electroacupuncture group were(46.18±1.87,53.36±1.10,P < 0.05).The increase and improvement of scores indicate that the balance function of patients has improved and recovered,and the improvement degree of combined treatment group is more significant than proprioception training group and electroacupuncture treatment group(P < 0.05).5.After 4 weeks of rehabilitation treatment,the proprioceptive function of the three groups was significantly better than that before treatment(P < 0.05).The changes of axial stability index of proprioceptive function before and after treatment in proprioceptive training group were(1.19 ± 0.39,0.65 ± 0.35,P < 0.05),and the changes of axial stability index of proprioceptive function before and after treatment in electroacupuncture group were(1.09±0.27,0.61 ± 0.26,P < 0.05)In the proprioceptive training combined with electroacupuncture treatment group,the changes of proprioceptive function observation index and axial stability index before and after treatment were(1.22 ± 0.46,0.43 ± 0.12,P < 0.05).The changes of left and right axis stability index of proprioception function before and after treatment in proprioception training group were(1.57 ± 0.42,0.90 ±0.24,P < 0.05),and the changes of left and right axis stability index of proprioception function before and after treatment in electroacupuncture treatment group were(1.38± 0.24,0.79 ± 0.19,P < 0.05)The changes of left and right axis stability index of proprioceptive function before and after treatment in proprioceptive training combined with electroacupuncture treatment group were(1.43 ± 0.41,0.49 ± 0.11,P< 0.05).The changes of A2-A6 stability index of proprioceptive function before and after treatment in proprioceptive training group were(1.44 ± 0.51,0.58 ± 0.27,P < 0.05),and the changes of A2-A6 stability index of proprioceptive function before and after treatment in electroacupuncture group were(1.12 ± 0.29,0.59 ± 0.17,P < 0.05)The changes of A2-A6 stability index of proprioceptive function before and after treatment in proprioceptive training combined with electroacupuncture treatment group were(1.62 ± 0.20,0.67 ± 0.19,P < 0.05).The changes of A4-A8 stability index of proprioceptive function before and after treatment in proprioceptive training group were(1.45 ± 0.27,0.68 ± 0.16,P < 0.05),and the changes of A4-A8 stability index of proprioceptive function before and after treatment in electroacupuncture group were(1.19 ± 0.24,0.74 ± 0.17,P < 0.05)The changes of A4-A8 stability index of proprioceptive function before and after treatment in proprioceptive training combined with electroacupuncture treatment group were(1.60 ± 0.21,0.76 ± 0.15,P < 0.05).The changes of SI of proprioceptive function before and after treatment in proprioceptive training group were(2.95 ± 0.87,1.79 ± 0.44,P < 0.05),and the changes of SI of proprioceptive function before and after treatment in electroacupuncture group were(2.82 ± 0.94,1.59 ± 0.53,P < 0.05)The changes of SI of proprioceptive function before and after treatment in proprioceptive training combined with electroacupuncture treatment group were(2.66 ± 0.60,1.21 ± 0.30,P< 0.05).The changes of ATE of proprioceptive function observation indexes before and after treatment in proprioceptive training group were(62.50 ± 8.46,28.14 ± 5.77,P <0.05),and the changes of ATE of proprioceptive function observation indexes before and after treatment in electroacupuncture group were(59.00 ± 13.39,33.48 ± 7.49,P< 0.05)The changes of ATE of proprioceptive function in proprioceptive training combined with electroacupuncture treatment group before and after treatment were(54.50 ± 10.51,13.85 ± 4.63,P < 0.05).The changes of execution time of proprioceptive function of servation indexes before and after treatment in proprioceptive training group were(96.46 ± 11.38,44.96± 9.18,P < 0.05),and the changes of execution time of proprioceptive function observation indexes before and after treatment in electroacupuncture treatment group were(97.34 ± 12.27,40.86 ± 6.37,P < 0.05)In the proprioceptive training combined with electroacupuncture treatment group,the changes of proprioceptive function observation index test execution time before and after treatment were(94.93 ± 12.29,35.10 ± 6.87,P < 0.05).The anterior and posterior axis stability index,left and right axis stability index,a2-a6 stability index,A4-A8 stability index,Si stability index,ate and test execution time decreased,indicating that the proprioceptive function of cervical spine was restored and improved,and the stability of cervical spine was improved.Combined with the treatment group,the anterior and posterior axis stability index,left and right axis stability index,Si stability index,ate The test execution time was more significant than that of proprioception training group and electroacupuncture treatment group(P < 0.05).6.After 4 weeks of rehabilitation treatment,the balance function of the three groups was significantly improved compared with that before treatment(P<0.05)。Among them,the changes of motor ellipse area of balance function observation index before and after treatment in proprioception training group were(362.18 ±109.72196.21 ± 58.59,P < 0.05),and the changes of motor ellipse area of balance function observation index before and after treatment in electroacupuncture treatment group were(369.10 ± 96.11236.28 ± 60.13,P < 0.05)The changes of motor ellipse area of balance function before and after treatment in proprioceptive training combined with electroacupuncture treatment group were(362.21 ± 42.58164.50 ±24.46,P < 0.05).The changes of movement length of the observation indexes of balance function before and after treatment in proprioception training group were(486.14 ±159.67232.21 ± 71.01,P < 0.05),and those in electroacupuncture treatment group were(433.31 ± 134.86255.07 ± 71.60,P < 0.05)The changes of movement length of balance function observation indexes before and after treatment in proprioceptive training combined with electroacupuncture treatment group were(431.71 ±65.20156.79 ± 11.45,P < 0.05).The changes of the stability limit of the observation indexes of balance function before and after treatment in proprioception training group were(53.18 ± 9.04,82.20± 6.79,P < 0.05),and those in electroacupuncture treatment group were(54.43 ± 7.45,73.47 ± 4.58,P < 0.05)The changes of stability limit of balance function observation indexes before and after treatment in proprioceptive training combined with electroacupuncture treatment group were(51.09 ± 6.03,88.18 ± 4.39,P < 0.05).The average motion ellipse area and motion length of the three groups decreased,and the average stability limit increased,indicating that the balance function of the three groups was restored and improved,and the recovery degree of the combined treatment group was more significant than that of the proprioceptive training group and electroacupuncture treatment group(P < 0.05).7.After 4 weeks of rehabilitation treatment,the cervical muscle function of the three groups was significantly improved compared with that before treatment(P <0.05).The changes of root mean square of sternocleidomastoid muscle before and after treatment in proprioception training group were(7.88 ± 3.53,15.08 ± 3.94,P <0.05),and the changes of RMS of sternocleidomastoid muscle before and after treatment in electroacupuncture treatment group were(6.91 ± 2.47,11.65 ± 3.40,P <0.05)The changes of RMS of sternocleidomastoid muscle in proprioceptive training combined with electroacupuncture treatment group were(6.70 ± 1.89,18.74 ± 3.55,P< 0.05).The RMS changes of trapezius muscle in proprioceptive training group before and after treatment were(4.40 ± 1.66,7.86 ± 2.39,P < 0.05),and the RMS changes of trapezius muscle in electroacupuncture group before and after treatment were(4.88 ±1.54,7.58 ± 1.74,P < 0.05)The RMS changes of trapezius muscle before and after treatment in proprioceptive training combined with electroacupuncture treatment group were(4.77 ± 1.52,15.68 ± 2.41,P < 0.05).The changes of MF of sternocleidomastoid muscle in proprioceptive training group before and after treatment were(61.25±8.75,82.04±9.58,P < 0.05),and that of sternocleidomastoid muscle in electroacupuncture group before and after treatment were(65.62±9.81,78.45±8.34,P < 0.05)The changes of MF of sternocleidomastoid muscle before and after treatment in proprioceptive training combined with electroacupuncture treatment group were(61.00±7.88,97.93±7.68,P < 0.05).The changes of MF of trapezius muscle before and after treatment in proprioceptive training group were(73.89±10.46,90.37±10.28,P < 0.05),and the changes of MF of trapezius muscle before and after treatment in electroacupuncture group were(76.86±9.86,92.45±7.90,P < 0.05)The changes of MF of trapezius muscle before and after treatment in proprioceptive training combined with electroacupuncture treatment group were(77.18±8.01,106.46±8.82,P < 0.05).The MF and RMS of sternocleidomastoid muscle and trapezius muscle in the three groups increased,indicating that the function of neck muscle was restored,the muscle strength was improved,and the muscle fatigue was reduced.And the increase of the combined treatment group was more significant than that of proprioception training group and electroacupuncture treatment group(P < 0.05).Experimental conclusion:Proprioceptive training,electroacupuncture,proprioceptive training combined with electroacupuncture are effective in the rehabilitation of patients with cervical spondylosis.Proprioceptive training combined with electroacupuncture is more effective in the treatment of cervical spondylosis of cervical type than proprioceptive training and electroacupuncture alone.It can improve patients’ cervical dysfunction,reduce pain,and promote the recovery of cervical proprioception,balance function and cervical muscle function.Electroacupuncture can improve the proprioceptive function and balance function of cervical spine.The specific potential theory needs to be further studied.