Analysis Of The Effect Of Hegu Acupuncture Activation Of Gluteal Muscle On Lower Limb Motor Function In Patients With Stroke Based On Surface Electromyography

Objective:To observe the electrophysiological changes of gluteal muscles of stroke patients by Hegu acupuncture using surface electromyography,and to evaluate their effects on lower limb motor function,walking ability and balance function by using related scales.Methods:The 64 patients were divided into Hegu acupuncture group and control group by randomized controlled method.In the end,each group completed 31 cases.Both groups received basic medical treatment,conventional acupuncture and rehabilitation training.Based on this,Hegu acupuncture group was performed on the affected side of Zhibian,Juliao and Huantiao.Both groups were treated for 4 weeks and 5 days a week.Before the first treatment and 4 weeks after treatment,the patients were tested for the surface electromyography of bilateral gluteus maximus,gluteus medius,and rectus femoris,and the changes of root mean square(RMS)and median frequency(MF)before and after treatment were observed.Before the first treatment,after 2 weeks of treatment and 4 weeks of treatment,patients were subjected to lower limb FMA,FAC classification and BBS score,follow-up of walking safety was performed two months after the end of the treatment cycle.Result:(1)Root mean square value(RMS)of the surface electromyography:(1)Weight bearing on the healthy side and stepping on the affected side: After treatment,the RMS of gluteus maximus and gluteus medius on the affected side of the Hegu acupuncture group increased(P<0.01),and the RMS of rectus femoris on the affected side decreased(P<0.05),the RMS of gluteus maximus and rectus femoris on the healthy side decreased(P<0.01),the RMS of gluteus medius on the healthy side decreased(P<0.05).In the control group,the RMS of gluteus maximus,gluteus medius and rectus femoris on the affected side increased,while the RMS of gluteus maximus and rectus femoris on the healthy side decreased(P<0.05),and the RMS of gluteus medius on the healthy side was equivalent before and after treatment(P>0.05).(2)Weight bearing on the affected side and stepping on the healthy side: After treatment,the RMS of gluteus maximus and gluteus medius on the affected side of the Hegu acupuncture group increased(P<0.01),the RMS of rectus femoris on the affected side increased(P<0.05),and the RMS of gluteus maximus on the healthy side decreased(P<0.01),the RMS of gluteus medius and rectus femoris on the healthy side decreased(P<0.05).In the control group,the RMS of gluteus maximus and gluteus medius on the affected side increased(P<0.05),the RMS of rectus femoris on the affected side increased(P<0.01),the RMS of gluteus maximus on the healthy side decreased(P<0.05),and the RMS of gluteus medius and rectus femoris on the healthy side were comparable before and after treatment(P>0.05).(2)Median frequency of surface electromyography(MF): In each action state,the MF increased in both gluteus maximus,gluteus medius and rectus femoris after treatment in both groups(P<0.01),while the MF of affected side in the Hegu acupuncture group were all higher than that in control group(P<0.01).(3)Lower limb FMA score: After overall analysis,P<0.01 at the time point and P<0.01 at the time point*group,the group's P<0.05.There was no difference in scores between thetwo groups after 2 weeks of treatment(P>0.05),and the score of the Hegu acupuncture group was higher than that of the control group after 4 weeks of treatment(P<0.01).(4)FAC assessment: After overall analysis,there was no difference between the two groups after 2 weeks of treatment(P>0.05).After 4 weeks of treatment,the Hegu acupuncture group was higher than the control group(P<0.01).The two groups were all related to time changes(P<0.05),and the correlation between Hegu acupuncture group and time was stronger than that of the control group.(5)BBS score: After the overall analysis,P<0.01 at the time point and P=0.01 at the time point*group,the group's P<0.05.There was no difference in scores between the two groups after 2 weeks of treatment(P>0.05),and the score of the Hegu acupuncture group was higher than that of the control group after 4 weeks of treatment(P<0.01).(6)Follow-up of walking safety: The incidence of falls in the Hegu acupuncture group was 3.23%,lower than 12.90% in the control group.Conclusion:Hegu acupuncture can effectively activate gluteal muscles on the affected side,and improve lower limb motor function,walking ability and balance function of stroke patients.