Objectives: To explore the effects of cluster needling at scalp points with needle retaining combined with the training of the upper-limb intelligent rehabilitation robot on shoulder function in stroke patients during convalescence.
Methods: Ninety stroke patients during convalescence were collected and randomized into scalp point group, robot training group and combined intervention group, with 30 cases each. In the scalp point group, the cluster needling was delivered at scalp points with the needles retained. In the robot training group, the patients were trained with the upper-limb intelligent rehabilitation robot. In the combined intervention group, the patients received both the cluster needling and the training of the upper-limb intelligent rehabilitation robot. In each group, the treatment was given once daily, 5 treatments a week with 2 days rest, for consecutive 4 weeks. Separately, before and after treatment, the score of Fugl-Meyer assessment upper extremity scale (FMA-UE) and the score of activity of daily living (ADL) were evaluated. Using the in-built assessment system of the upper-limb intelligent rehabilitation robot, the range of motion (ROM) of forward flexion, horizontal abduction and horizontal adduction of the affected shoulder joint were evaluated. With surface electromyogram (sEMG), the sEMG value of the deltoid muscle and the pectoralis major on the affected side were detected.
Results: Compared with the values before treatment, ADL score and FMA-UA score increased in patients of the three groups (P<0.05), and ROM of forward flexion, horizontal abduction and horizontal adduction of the affected shoulder joint was larger (P<0.05), the sEMG value of the fasciculi pectoralis major anterior of patients in the combined intervention group was reduced (P<0.05), and the sEMG of anterior deltoid tract was elevated in the three groups (P<0.05). When compared with the scalp point group and the robot group, in the combined intervention group, after treatment, ADL score and FMA-UA score were higher (P<0.05), ROM of forward flexion, horizontal abduction and horizontal adduction of the affected shoulder joint elevated (P<0.05) and sEMG value of the fasciculi pectoralis major anterior reduced (P<0.05), while which of the anterior deltoid tract was elevated (P<0.05).
Conclusions: The cluster needling at scalp points with needle retaining, combined with the training of the upper-limb intelligent rehabilitation robot, improves the upper limb motor function and the range of motion of the shoulder joint in stroke patients during convalescence.
目的: 探讨头穴丛刺留针结合上肢智能康复机器人对脑卒中恢复期患者肩关节功能的影响。方法: 选取脑卒中恢复期的90例患者，随机分为头穴组、机器人组以及联合组，每组30例。头穴组头穴丛刺留针干预，机器人组给予上肢智能康复机器人训练，联合组给予头穴丛刺留针和上肢康复机器人训练。3组患者均1次/d，5 d/周，连续4周。分别评价治疗前后Fugl-Meyer运动功能评定—上肢部分（FMA-UE）评分、日常生活能力量表（ADL）评分。通过上肢智能康复机器人内嵌评估系统评估患侧上肢肩关节前屈、水平内收、水平外展活动度。采用表面肌电图检测患者上肢三角肌及胸大肌的表面肌电值（sEMG）。结果: 与干预前比较，干预后3组患者FMA-UE评分和ADL评分显著升高（P<0.05），患侧肩关节前屈、水平内收、水平外展活动度明显增加（P<0.05）；联合组患者胸大肌前束的sEMG降低，3组患者三角肌前束的sEMG均升高（P<0.05）。与头穴组和机器人组比较，联合组干预后FMA-UE评分和ADL评分明显升高（P<0.05），患侧肩关节前屈、水平内收、水平外展关节活动度明显增加（P<0.05），胸大肌前束sEMG明显降低（P<0.05），三角肌前束sEMG明显升高（P<0.05）。结论: 头穴丛刺留针联合上肢康复机器人训练可改善脑卒中恢复期患者上肢运动功能与肩关节活动度。.
Keywords: Cluster needling at scalp points with needle retaining; Convalescence; Shoulder function; Stroke; Upper-limb intelligent rehabilitation robot.