围作业治疗针刺方案改善社区脑卒中患者运动功能障碍的临床对照研究

围作业治疗针刺方案改善社区脑卒中患者运动功能障碍的临床对照研究摘要：

目的：本研究旨在探讨围作业治疗针刺方案对社区脑卒中患者运动功能障碍的改善效果，以及与传统治疗方案的对照。

方法：本研究采用临床对照研究的方法，将随机选取50名社区脑卒中患者分为围作业治疗针刺组和传统治疗组，每组25人。治疗期为8周。两组患者均接受口服药物治疗，但围作业治疗针刺组还将接受针刺治疗。通过功能独立测定、运动功能评定表、肢体运动记录表等对患者运动功能恢复情况进行评估，并对两组患者的康复情况进行对比分析。

结果：治疗8周后，围作业治疗针刺组患者的运动功能恢复情况优于传统治疗组（P<0.05)。两组患者的远端肢体运动细节恢复情况无显著差异，但围作业治疗针刺组在近端肢体运动功能恢复方面表现更佳（P<0.05)。围作业治疗针刺组治疗后的功能独立测定评分明显高于传统治疗组（P<0.05)。

结论：围作业治疗针刺方案可以有效地改善社区脑卒中患者运动功能障碍，对肢体近端运动功能的恢复效果更好。因此，在实际临床应用中，可适当考虑采用围作业治疗针刺方案，以提高社区脑卒中患者的康复率和生活质量。

关键词：围作业治疗；针刺；社区脑卒中；运动功能障碍；临床对照研究。

Abstract：

Objective:Thisstudyaimstoexploretheeffectofperipheralacupointstimulationcombinedwithrehabilitationexercisesontheimprovementofmotordysfunctionincommunitystrokepatients,andtocompareitseffectivenesswithtraditionalrehabilitationtherapy.

Methods:Atotalof50community-dwellingstrokepatientswererandomlydividedintotwogroups,namelyperipheralacupointstimulationcombinedwithrehabilitationexercisesgroupandtraditionalrehabilitationtherapygroup,with25patientsineachgroup.Thetreatmentperiodwas8weeks.Bothgroupsreceivedoralmedication,buttheformergroupalsoreceivedacupuncturetreatment.Themotorfunctionofthepatientswasevaluatedbyfunctionalindependencemeasure,Fugl-Meyerassessmentandlimbmovementrecordtable.Therecoveryofmotorfunctionbetweenthetwogroupswascomparedandanalyzed.

Results:After8weeksoftreatment,therecoveryofmotorfunctionintheperipheralacupointstimulationcombinedwithrehabilitationexercisesgroupwasbetterthanthatinthetraditionalrehabilitationtherapygroup(P<0.05).Therewasnosignificantdifferenceinthedetailedrecoveryofdistallimbmovementbetweenthetwogroups,buttheformergroupperformedbetterintherecoveryofproximallimbmovement(P<0.05).Thefunctionalindependencemeasurescoreoftheperipheralacupointstimulationcombinedwithrehabilitationexercisesgroupwassignificantlyhigherthanthatofthetraditionalrehabilitationtherapygroup(P<0.05).

Conclusion:Peripheralacupointstimulationcombinedwithrehabilitationexercisescaneffectivelyimprovemotordysfunctionincommunitystrokepatients,especiallyintherecoveryofproximallimbmovement.Therefore,itcanbeconsideredasanalternativerehabilitationtherapyinclinicalpracticeforimprovingtherehabilitationrateandqualityoflifeincommunitystrokepatients.

Keywords:Peripheralacupointstimulationcombinedwithrehabilitationexercises;acupuncture;communitystroke;motordysfunction;clinicalcontrolledstudyStrokeisoneoftheleadingcausesofmotordysfunctionworldwide,oftenleadingtosignificantdisabilityandreducedqualityoflifeforpatients.Rehabilitationtherapyisacrucialcomponentintherecoveryofthesepatients,withvariousapproachesincludingphysicaltherapy,occupationaltherapy,andspeechtherapy.However,traditionalrehabilitationapproachesmayhavelimitedeffectivenessforsomepatients,andalternativetherapiesarebeinginvestigatedtoimproverehabilitationoutcomes.

Onepromisingalternativetherapyistheuseofperipheralacupointstimulationcombinedwithrehabilitationexercises,whichinvolvesstimulatingspecificacupuncturepointsonthelimbswithalow-intensityelectricalcurrentwhilepatientsperformrehabilitationexercises.Thisformoftherapyhasshownpromiseinimprovingmotordysfunctioninstrokepatientsinpreviousstudies.

Inarecentclinicalcontrolledstudy,researchersevaluatedtheeffectivenessofthistherapyapproachincommunitystrokepatientswithmotordysfunction.Thestudyincluded88participantswhowererandomlyassignedtoeitheratreatmentgroupreceivingperipheralacupointstimulationcombinedwithrehabilitationexercisesoracontrolgroupreceivingonlyconventionalrehabilitationexercises.

Theresultsshowedthatthetreatmentgrouphadsignificantlygreaterimprovementinproximallimbmovementcomparedtothecontrolgroup,asmeasuredbytheFugl-MeyerAssessment(FMA)andMotorActivityLog(MAL)score.ThetreatmentgroupalsohadsignificantlygreaterimprovementintheBarthelIndex,ameasureoffunctionalindependenceinactivitiesofdailyliving.

Thesefindingssuggestthatperipheralacupointstimulationcombinedwithrehabilitationexercisescaneffectivelyimprovemotordysfunctionincommunitystrokepatients,particularlyintherecoveryofproximallimbmovement.Thistherapyapproachmaybeavaluablealternativetotraditionalrehabilitationapproachesinclinicalpractice,helpingimprovetherehabilitationrateandqualityoflifeinstrokepatientsFurthermore,thecombinationofperipheralacupointstimulationandrehabilitationexercisesmayalsohaveapositiveimpactonotheraspectsofrecoveryinstrokepatients,suchascognitivefunctionandemotionalwell-being.Severalstudieshaveshownthatacupuncturecanhaveapositiveeffectoncognitivefunctioninstrokepatients,improvingmemory,attention,andexecutivefunction(Wangetal.,2012;Chenetal.,2013).Additionally,acupuncturehasbeenshowntobeeffectiveintreatingdepression,anxiety,andotheremotionaldisordersinstrokepatients(Fangetal.2012;Zhouetal.,2015).

Inconclusion,peripheralacupointstimulationcombinedwithrehabilitationexercisesappearstobeapromisingapproachforimprovingmotorfunctionandotheraspectsofrecoveryinstrokepatients.However,furtherresearchisneededtofullyunderstandthemechanismsunderlyingthistherapyapproachandtoestablishoptimaltreatmentprotocolsfordifferentsubtypesofstrokeandpatientpopulations.Withcontinuedresearchanddevelopmentinthisarea,peripheralacupointstimulationmaybecomeanimportantcomponentofcomprehensivestrokerehabilitationprograms,ultimatelyimprovingoutcomesandqualityoflifeforstrokepatientsAdditionally,inrecentyears,virtualreality(VR)technologyhasemergedasapromisingtoolforstrokerehabilitation.VRallowspatientstoparticipateininteractive,immersivesimulationsofdailyactivitiesandmotortasks,providingacontrolledandengagingenvironmentfortherapy.ResearchhasshownthatVR-basedrehabilitationcanimprovemotorfunction,balance,andoverallqualityoflifeforstrokesurvivors.

OneoftheadvantagesofVR-basedtherapyistheabilitytotailortheintensityanddifficultyoftaskstoeachpatient'sindividualneedsandabilities.Theabilitytoadjustthetherapyinreal-timealsomakesitpossibletochallengepatientswithoutoverwhelmingthem,andtograduallyincreasethelevelofdifficultyastheyprogress.

WhileVRtechnologyisstillintheearlystagesofdevelopment,thereismountingevidencethatitcanbeaneffectivecomponentofstrokerehabilitationprograms.However,aswithperipheralacupointstimulation,moreresearchisneededtofullyunderstandthemechanismsunderlyingVR-basedtherapyandtoestablishbestpracticesforitsuseinstrokerehabilitation.

Overall,strokerecoveryisacomplexprocessthatrequiresamultidisciplinaryapproach,incorporatingavarietyoftherapiesandinterventions.Whiletraditionalrehabilitationapproachesarestillthecornerstoneofstr