| Objective:This study investigated the clinical efficacy of real-time combined isokinetic training with head acupuncture and Isometric training after head acupuncture in the of upper limbs of patients with stroke hemiplegia,to investigate whether real-time combined isokinetic training with head acupuncture is superior to post-head acupuncture isokinetic training,and to supplement the gap in the choice of time point for combined head acupuncture and isokinetic training,in order to optimize the clinical treatment plan of combined isokinetic training with head acupuncture for stroke hemiplegia,and to provide a basis for the clinical treatment plan of real-time combined isokinetic training with head acupuncture.Methods: The 40 patients with hemiplegia who met the inclusion requirements were numbered in order of entry and randomly divided into a pilot group and a control group;test group: conventional treatment +head acupuncture real-time combined with isokinetic treatment(isokinetic training with head acupuncture in the afternoon);control group: conventional treatment + isokinetic treatment after head acupuncture(head acupuncture in the morning and isokinetic training in the afternoon).Head acupuncture treatment:Patient in sitting or recumbent position,and needles were applied at the middle 2/5 of the anterior parietotemporal oblique line,middle 2/5 of the posterior parietotemporal oblique line and the parietal 2 lines on the opposite side of the hemiplegia,firstly,After routine disinfection with 75% ethanol wipes,the needle tip was stabbed into the subcutaneous at an angle of45° to the scalp to reach the subcapsular fascia,and then stabbed rapidly along the subcutaneous at an angle of 15°,after entering the needle,the needle was twisted at a speed of 200 rpm for 1～2min.2 min,respectively,after the needle is inserted and when the needle is left for 15 min,once each time,30 min after the needle is discharged,when the needle is discharged,the needle is first slowly retreated to the subcutaneous,and then quickly withdrawn,after the needle is withdrawn,the needle hole should be pressed in time to prevent bleeding;the trialal group performed the head needle operation after the patient was fixed in the isokinetic training machine seat,after the needle is inserted,the isokinetic training is performed with the needle,after 15 min of training,the second time is done during the interval of 5 min After 15 minutes of training,a second row of needles was performed during a 5-minute interval,and the needles were discharged at the end of the isokinetic training(30minutes later).In the control group,the first needle treatment is performed in the morning and the isokinetic training is performed in the afternoon.Isokinetic treatment: The patient sits on the isokinetic machine seat and fixes the body,setting the angle between the seat and the head of the machine to 0o,Adjust the robotic arm to the appropriate scale for the length of the subject’s affected arm,instructing the subject to relax the shoulder and fix the wrist and hand with a bandage on the grip of the arm,instructing the patient to warm up for about 2min before the test or training,and then try to do shoulder flexion and extension exercises for the isokinetic muscle strength test The exercise mode is isokinetic muscle training mode,with angular velocity of 60°/s,90°/s,25 flexion and extension exercises per angular velocity for1 set,2 sets each time,with 5 min rest at interval,total 30 min.The hemiplegic limb rehabilitation training was individualized by a professional rehabilitation therapist,with exercise therapy and occupational therapy as the main components,together with physiotherapy,including the placement of good limbs,Joint mobility training,muscle strength training,balance training,upper limb control training,walking training,etc.Duration of treatment: Patients in both groups were treated once a week from Monday to Saturday,with one day off on Sunday,in a 2-week period,with 2 courses of therapy observed,for a total of 4 weeks of treatment..Evaluation indexes: The Fugl-Meyer upper limb motor function assessment scale(FMA),the Modified Ashworth Scale(MAS)and the isometric muscle strength tester were used to assess the patients before and after the test and the relevant data were recorded.Statistical analysis: Statistical analysis was carried out by checking the number of subjects planned to be included,the number of subjects actually completed,and the number of subjects excluded and dislodged;then the relevant demographic and other baseline characteristics of the patients in the two groups at the time of enrolment were analysed to examine the comparability between the test and control groups;later,the SPSS software package was used for analysis,The qualitative data were analysed using the chi-square test and the quantitative data conforming to the normal distribution were analysed using the t-test,where the comparison was made between groups using the independent samples t-test and within groups using the pairwise t-test.,and non-conformity with normal distribution was analysed using the rank sum test or analysis of covariance,with P≤0.05 being considered statistically significant and P ≤ 0.01 being considered highly statistically significant.Results: There was no significant difference between the general data of the two groups before the trial(P>0.05),and the two groups were comparable;there was no significant difference between the FMA score,MAS score and PT value of the two groups before the trial(P>0.05);after the trial,the PT value of the two groups increased significantly(P<0.01),and the trialal group was higher than the control group(P<0.05);after the trial,the FMA score of the two groups increased significantly(P<0.01),and the trialal group was higher than the control group(P<0.01);there was no significant difference in MAS scores between the two groups after treatment(P>0.05).Conclusion: 1.The treatment protocol of head acupuncture combined with isokinetic training can significantly improve the motor function of the affected upper limb in patients with stroke hemiplegia,and it does not increase the muscle tone of patients while improving the motor function;2.By contrast the efficacy of the two groups after 4 weeks of treatment,it was found that the treatment effect of the head acupuncture real-time combined with isokinetic group was better than that of the isokinetic group after head acupuncture. |
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