Three-dimensional kinematic analysis can improve the efficacy of acupoint selection for post-stroke patients with upper limb spastic paresis:A randomized controlled trial  

作　　者：Xin-yun Huang Ou-ping Liao Shu-yun Jiang Ji-ming Tao Yang Li Xiao-ying Lu Yi-ying Li Ci Wang Jing Li Xiao-peng Ma 

机构地区：[1]Acupuncture Center,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China [2]Yueyang Clinical Medical College,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China [3]Gait and Motion Analysis Center,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China [4]Department of Rehabilitation,Shuguang Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China [5]Shanghai Research Institute of Acupuncture and Meridian,Shanghai 200030,China

出　　处：《Journal of Integrative Medicine》2025年第1期15-24,共10页结合医学学报(英文版)

基　　金：funded by Science Foundation for Youth supported by Shanghai Municipal Health Commission(No.20204Y0313);Sailing Program with the support of Science and Technology Commission of Shanghai Municipality(No.21YF1443800).

摘　　要：Background China is seeing a growing demand for rehabilitation treatments for post-stroke upper limb spastic paresis(PSSP-UL).Although acupuncture is known to be effective for PSSP-UL,there is room to enhance its efficacy.Objective This study explored a semi-personalized acupuncture approach for PSSP-UL that used three-dimensional kinematic analysis(3DKA)results to select additional acupoints,and investigated the feasibility,efficacy and safety of this approach.Design,setting,participants and interventions This single-blind,single-center,randomized,controlled trial involved 74 participants who experienced a first-ever ischemic or hemorrhagic stroke with spastic upper limb paresis.The participants were then randomly assigned to the intervention group or the control group in a 1:1 ratio.Both groups received conventional treatments and acupuncture treatment 5 days a week for 4 weeks.The main acupoints in both groups were the same,while participants in the intervention group received additional acupoints selected on the basis of 3DKA results.Follow-up assessments were conducted for 8 weeks after the treatment.Main outcome measures The primary outcome was the Fugl-Meyer Assessment for Upper Extremity(FMA-UE)response rate(≥6-point change)at week 4.Secondary outcomes included changes in motor function(FMA-UE),Brunnstrom recovery stage(BRS),manual muscle test(MMT),spasticity(Modified Ashworth Scale,MAS),and activities of daily life(Modified Barthel Index,MBI)at week 4 and week 12.Results Sixty-four participants completed the trial and underwent analyses.Compared with control group,the intervention group exhibited a significantly higher FMA-UE response rate at week 4(χ^(2)=5.479,P=0.019)and greater improvements in FMA-UE at both week 4 and week 12(both P<0.001).The intervention group also showed bigger improvements from baseline in the MMT grades for shoulder adduction and elbow flexion at weeks 4 and 12 as well as thumb adduction at week 4(P=0.007,P=0.049,P=0.019,P=0.008,P=0.029,respectively).The intervention group sh

关 键 词：STROKE Spastic paresis Upper limb ACUPUNCTURE Kinematic analysis REHABILITATION 

分 类 号：R743.3[医药卫生—神经病学与精神病学]