针康法促进脑卒中后下肢运动功能重建的功能性近红外光谱研究

doi:10.3969/j.issn.1006-9771.2022.01.005

Abstract

Abstract:

Objective To investigate the efficacy of acupuncture and rehabilitation therapy on lower limb motor function, and to explore a cortical mechanism using functional near infrared spectroscopy (fNIRS). Methods From December, 2020 to July, 2021, 24 stroke patients with lower limb motor dysfunction in our hospital were randomly divided into rehabilitation group (n = 12) and acupuncture-rehabilitation group (n = 12), and received routine rehabilitation training and acupuncture-rehabilitation intervention for four weeks, respectively. The control group included ten healthy subjects matched the patients. Before and after intervention, the lower limb motor function of the patients was assessed with Fugl-Meyer Assessment-Lower Extremities (FMA-LE), and all the subjects accepted fNIRS examination. The functional intensity and lateralization index (LI) of supplementary motor area (SMA), premotor cortex (PMC) and sensory motor cortex (SMC) were calculated based on oxygenated hemoglobin (HbO₂). Results There was no significant difference in FMA-LE score between the rehabilitation group and the acupuncture-rehabilitation group before the intervention (P > 0.05). After four weeks of intervention, FMA-LE scores improved in both groups (t > 3.770, P < 0.001), and improved more in the acupuncture-rehabilitation group than in the rehabilitation group (t = 2.252, P < 0.05). Before intervention, the average functional connection was more intensitive in the control group than in the two patients groups (P < 0.05), and there was no significant difference between the later two groups (t = 0.458, P > 0.05). After intervention, the average functional connection increased in both groups (t > 2.178, P < 0.05), and the functional connection of the affected PMC of acupuncture-rehabilitation group increased (P < 0.05). The LI in SMC increased in the acupuncture-rehabilitation group (P < 0.05). There was a significant positive correlation between the change of functional connection of the affected PMC and the change of FMA-LE scores in the acupuncture-rehabilitation group (r = 0.579, P < 0.05). Conclusion Acupuncture with rehabilitation therapy can significantly improve the lower limb motor function and asymmetrical activation of SMC in stroke patients. The recovery of lower limb motor function may be related to the enhanced activation of affected PMC.

Key words: stroke, acupuncture and rehabilitation therapy, functional near infrared spectroscopy, cortical reorganization

CLC Number:

R743.3

TANG Qiang,WANG Xue,MU Zichen,ZHANG Shiqiang,ZHU Luwen. Effects of acupuncture and rehabilitation therapy on lower limb motor function after stroke: an fNIRS study[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(1): 32-37.

Figures/Tables 7

References 30

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组别	n	性别 (男/女)/n	年龄/岁	病程/d	病变性质 (缺血/出血)/n	瘫痪侧别 (左/右)/n	MMSE
对照组	10	9/1	46.10±11.00	—	—	—	30.10±1.20
康复组	12	11/1	51.91±4.63	40.08±9.20	9/3	6/6	29.18±0.97
针康组	12	11/1	53.50±6.00	35.60±12.87	8/4	5/7	28.75±0.83
χ²/F值		0.444	2.628	0.293	0.202	0.168	0.276
P值		0.801	0.088	0.594	0.653	0.682	0.705

组别	n	干预前	干预后	t值	P值
康复组	12	17.91±4.83	24.32±3.37	3.770	< 0.001
针康组	12	18.50±3.72	27.78±4.12	5.791	< 0.001
t值		0.335	2.252
P值		0.741	0.035

组别	n	干预前	干预后	t值	P值
针康组	12	0.36±0.17	0.49±0.11	2.224	0.037
康复组	12	0.33±0.15	0.44±0.09	2.178	0.040
t值		0.458	1.219
P值		0.651	0.236

Effects of acupuncture and rehabilitation therapy on lower limb motor function after stroke: an fNIRS study

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