康复学报2025，Vol.35Issue(3)：298-306,9.DOI:10.3724/SP.J.1329.2025.03010
双侧经皮穴位电刺激联合阶梯式任务导向训练对脑卒中患者上肢功能障碍的影响
Effects of Bilateral Transcutaneous Electrical Acupoint Stimulation Combined with Stepped Task-Oriented Training on Upper Limb Dysfunction in Stroke Patients
摘要
Abstract
Objective To investigate the effects of bilateral transcutaneous electrical acupoint stimulation(TEAS)combined with stepped task-oriented training(STOT)on upper limb dysfunction in stroke patients.Methods A total of 78 inpatients in the Department of Rehabilitation Medicine of Shanghai Third Rehabilitation Hospital from November 2021 to June 2024 were recruited and randomly divided into control group,bilateral TEAS group and combined intervention group by random number table method,with 26 cases in each group.One patient in the combined intervention group dropped out due to early discharge.Finally,26 patients in the control group,26 patients in the bilateral TEAS group and 25 patients in the combined intervention group completed all evalu-ations and treatments.All three groups received conventional rehabilitation treatment(including active and passive limb movement,appropriate limb positioning,physical agent modalities,activities of daily living training,and traditional Chinese medicine treat-ments such as massage and manipulation).The treatment was 3 hours per day,5 days per week for 4 weeks.In addition to the con-ventional treatment,the control group received TEAS treatment at Shousanli(LI10)and Waiguan(SJ5)acupoints of the hemiplegic upper limb and received upper limb occupational therapy(OT)training;the bilateral TEAS group received TEAS treatment at LI0 and SJ5 acupoints of both upper limbs and received OT training of the hemiplegic upper limb;the combined intervention group re-ceived bilateral TEAS treatment at LI0 and SJ5 acupoints combined with STOT of the hemiplegic upper limb.The TEAS treatment,upper limb OT training and STOT in the three groups were performed for 30 minutes per day,5 days per week for 4 weeks.Before and after treatment,the Fugl-Meyer Assessment of Upper Extremity(FMA-UE)and the Box and Block Test(BBT)were used to evaluate upper limb motor function.The Modified Ashworth Scale(MAS)was used to assess the muscle tone of the elbow and wrist flexors in patients,and the Modified Barthel Index(MBI)scale was used to evaluate the patients'ability to perform activities of daily living.Scores before and after treatment,as well as within-group changes in scores(post-treatment minus pre-treatment),were com-pared among the three groups.Results Compared with pre-treatment,the total score,the proximal function score,and the distal function score of FMA-UE in the three groups all increased after treatment(P<0.05);compared with the control group and the bilat-eral TEAS group,the changes of FMA-UE scores(post-treatment minus pre-treatment)in the combined intervention group were sig-nificantly greater(P<0.05).Compared with pre-treatment,BBT scores of the three groups all increased after treatment(P<0.05);compared with the control group and the bilateral TEAS group,BBT scores of the combined intervention group were significantly higher(P<0.05).Compared with the control group and the bilateral TEAS group,the changes of BBT scores(post-treatment minus pre-treatment)in the combined intervention group were also greater(P<0.05).Compared with pre-treatment,MBI scores of the three groups all increased after treatment(P<0.05).Conclusion Unilateral TEAS,bilateral TEAS,and bilateral TEAS combined with STOT can all effectively improve the upper extremity motor function of stroke patients,but the combined intervention has shown more significant therapeutic effect.关键词
脑卒中/上肢功能障碍/经皮穴位电刺激/阶梯式任务导向训练/左右协同与制衡理论Key words
stroke/upper limb dysfunction/transcutaneous electrical acupoint stimulation/stepped task-oriented training/left-right coordination and balance theory引用本文复制引用
项育枝,王鹤玮,刘兰兰,陈逸浩,曹叶凡,陈瑶..双侧经皮穴位电刺激联合阶梯式任务导向训练对脑卒中患者上肢功能障碍的影响[J].康复学报,2025,35(3):298-306,9.基金项目
国家自然科学基金青年科学基金项目(82102665) （82102665）
上海市科学技术委员会"扬帆计划"基金(21YF1404600) （21YF1404600）
上海市静安区卫生科研课题面上项目(2021MS17) （2021MS17）
上海市静安区卫生系统重点学科建设资助项目(2021PY04) （2021PY04）
