The Journal of Korean Medicine (대한한의학회지)

The Society of Korean Medicine (대한한의학회)
권호 표지

Effects of Electroacupuncture on the Hemiplegic Upper Extremity after Stroke

중풍 환자의 상지마비에 대한 전침치료의 효과

  • 류순현 (경희대학교 한의과대학 2내과학교실) ;
  • 이경섭 (경희대학교 한의과대학 2내과학교실) ;
  • 김태경 (경희대학교 한의과대학 2내과학교실) ;
  • 최요섭 (경희대학교 한의과대학 2내과학교실) ;
  • 윤상필 (경희대학교 한의과대학 2내과학교실) ;
  • 장종철 (경희대학교 한의과대학 2내과학교실) ;
  • 문상관 (경희대학교 한의과대학 2내과학교실) ;
  • 고창남 (경희대학교 한의과대학 2내과학교실) ;
  • 조기호 (경희대학교 한의과대학 2내과학교실)
  • Published : 2002.06.01
Download PDF
⟨ Previous Next ⟩

Abstract

Background and Purpose : The hemiplegic upper extremity is affected in many stroke patients, and recovery is often poor. The purpose of this study was to assess the efficacy of electroacupuncture (EA) in enhancing the upper extremity motor and functional recovery of ischemic stroke patients. Subjects and Methods : Forty ischemic stroke patients (the upper extremity Fugl-Meyer motor scale (FM) score lower than 46, lesion location within middle cerebral artery territory) within 2 weeks of stroke onset were randomly allocated to either an EA group that received EA treatment or a control group that received only routine ward care. The EA was applied at Quchi-Shousanli (LI11-LI10), Waiguan-Hegu (TE5-LI4) points on the hemiparetic side six times per week for 4 weeks. The frequency of stimulation was 25-50Hz and the intensity was set at a level sufficient to induce muscle contraction. EA treatment was given for 30 minutes and all patients of both groups received standard rehabilitation program. Outcomes were assessed, in a blind manner, before treatment began and at 4 weeks after treatment, with the FM, the Motor Power score (MP) for shoulder/elbow, and the subsection of the Modified Barthel Index (MBI) for drinking/feeding/dressing upper body/grooming. Results : These 2 groups had comparable clinical characteristics, lesion location, lesion size, and pretreatment impairment scores. By the end of treatment, the EA group showed significantly more improvement than the control group in the subsection of the FM for shoulder/elbow/coordination (6.4 vs. 3.7; P=0.047) and the MP for shoulder/elbow (5.3 vs. 3.3; P=0.008). The subsection scores of the MBI for drinking/feeding/dressing upper body/grooming were not significantly different between two groups. No adverse effects due to treatment were found Conclusion : These results suggest that EA enhances the upper extremity motor recovery of acute stroke patients. However, this study failed to demonstrate any significant functional benefit related with upper extremity. Future study should be carried out in a larger sample size and use the functional outcome measure that is more specific and sensitive to the upper extremity.

Keywords

References

  1. 임상중풍학 김영석
  2. J Neurol Neurosurg Psychiatry v.46 Recovery after stroke. Skilbeck CE;Wade DT;Hewer RL;Wood VA
  3. Int Disabil Stud v.11 Measuring arm impairment and disability after stroke Wade DT
  4. Int Disabil Stud. v.12 Gait recovery after hemiplegic stroke Friedman PJ
  5. Arch Phys Med Rehabil v.67 Slot machine: their use in rehabilitation after stroke Smedley RR;Fiorino AJ;Soucar E;Reynolds D;Smedley WP;Aronica MJ
  6. Arch Phys Med Rehabil v.74 Technique to improve chronic motor deficit after stroke Taub E;Miller NE;Novack TA;Cook EW;Fleming WC;Nepomuceno CS;Connell JS;Crago JE
  7. Neurology v.53 Robot training enhanced motor outcome in patients with stroke maintained over three years Volpe BT;Krebs HI;Hogan N;Edelstein L;Diels C;Aisen M
  8. Stroke v.29 Neuromuscular stimulation for upper extremity motor and functional recovery in acute hemiplegia Chae J;Bethous F;Bohinc T;Dobos L;Davis T;Friedl A
  9. Stroke v.30 Electrical stimulation of wrist extensors in poststroke hemiplegia Powell J;Pandyan AD;Granat M;Cameron M;Stott DJ
  10. Am J Acupuncture v.21 Effective acupuncture therapy for stroke and cerebrovascular disease:Part I. Chen A
  11. Acupunct Electrother Res v.15 108 cases of hemiplegia caused by stroke: the relationship between CT scan results, clinical findings and the effect of acupuncture treatment Chen YM;Fang YA
  12. Neurology v.43 Can sensory stimulation improve the functional outcome in stroke patients? Johansson K;Lindgren I;Widner H;Wiklund I;Johansson BB
  13. Neuroepidemiology v.12 A randomized controlled trial on the treatment for acute patial ischemic stroke with acupuncture Hu HH;Chung C;Liu TJ;Chen RC;Chen CH;Chou P;Huang WS;Lin JCT;Tsuei JJ
  14. Acupunct Electrother Res v.19 no.4 Acupuncture in the treatment of paralysis in chronic and acute stroke patients: Improvement correlated with specific CT scal lesion sites Naeser MA;Alexander MP;Stiassny-Elder D;Galler V;Hobbs J;Bachman D
  15. Clin Rebabil v.11 A one year follow-up study on the effects of acupucture in the treatment of stroke patients in the subacute stage: a randomized, controlled study Kjendahl A;Sallstrom S;sten PE;Stanghelle JK
  16. Am J Phys Med Rehabil v.78 no.2 Clinical trial of electrical acupuncture on hemiplegic stroke patients Wong AM;Su TY;Tang FT;Cheng PT;Liaw MY
  17. Stroke v.29 no.10 Effects of acupuncture treatment on daily life activities and quality of life. A controlled, prospective, and randomized study of acute stroke patients Gosman-Hedstrom, G;Claesson L;Klingenstierna U;Carlsson J;Olausson B;Frizell M;Fagerberg B;Blomstrand C
  18. Scand J Rehabil Med v.7 The poststroke hemiplegic patient, I: a method for evaluation of physical performance Fugl-Meyer AR;Jaasko L;Leyman I;Olsson S;Steglind S
  19. Phys ther. v.73 Reliability of the Fugl-Meyer assessment for testing motor performance in patients following stroke Sanford J;Moreland J;Swanson LR;Stratford PW;Gowland C
  20. 경희의학 v.13 no.4 뇌경색 환자의 혈압, 맥박 및 뇌혈류에 대하여 수구-승장혈 전침자극이 미치는 영향 박성욱;문상관;고창남;조기호;김영석;배형섭;이경섭
  21. 경희의학 v.16 no.1 뇌경색 환자의 뇌혈류에 대하여 건측 및 환측 침치료가 미치는 영향에 관한 비교 연구 문상관;조기호;고창남;김영석;배형섭;이경섭
  22. 대한침구학회지 v.14 no.1 중풍마비에 활용된 애구법의 임상응용에 관한 연구 윤병현;김갑성
  23. 한방재활의학과학회지 v.9 no.1 전침과 근력 운동이 하지 골격근의 근섬유 조성과 혈중 호르몬에 미치는 영향 오재근;정석회;이종수;김성수;신현대
  24. 혜화의학 v.1 no.2 중풍의 침구치료에 대한 문헌적 고찰 안택원;변일
  25. J Neurol Neurosurg Psychiatry v.46 The hemiplegic arm after stroke: measurement and recovery Wade DT;Langton-Hewer R;Wood VA;Skilbeck CE;Ismail HM
  26. Am J Phys Med Rehabil v.74 no.3 Admission motor impairment as a predictor of physical disability after stroke rehabilitation Chae J;Johnston M;Kim HK;Zorowitz R
  27. Stroke v.23 no.8 Measurement of motor recovery after stroke: outcome assessment and sample size requirements Duncan PW;Goldstein LB;Matchar D;Divine GW;Feussner J
  28. Arch Phys Med Rehabil v.76 Outcome and time course of recovery in stroke. Part II: Time course of recovery: the Copenhagen Stroke Study Jorgensen H;Nakayama H;Raaschon H;Vive-Larsen J;Stoier M;Olsen T
  29. Acupunct Electrother Res v.1 no.1 Pathophysiology of acupuncture treatment: Effects of acupuncture on cardiovascular and nervous system Omura Y
  30. 경희의학 v.9 수구혈 전침자극이 실험적 뇌경색의 국소 뇌혈류량에 미치는 영향 윤상협
  31. American J Acupuncture v.24 Obsevaitons on brain perfusion before and after acupuncture treatment of phantom limb pain: a case report Liaw MY;You DL;Cheng PT;Wong AM;Lu CS
  32. Am J Phys Med Rehabil v.80 no.1 Functional MRI evidence of cortical reorganization in upper-limb stroke hemiplegia treated with constraint-induced movement therapy Levy CE;Nichols DS;Schmalbrock PM;Keller P;Chakeres DW
  33. 대한침구학회지 v.18 no.2 족삼리 전침자극이 뇌혈류에 미치는 영향에 관한 핵의학적 고찰 김일두;오희홍;송호천;범희승;변재영;안수기
  34. Ann Neurol v.29 The functional anatomy of motor recovery after stroke in humans: A study with Positron Emission Tomography Chollet F;Dipiero V;Wise RJ;Brooks DJ;Doran RJ;Frackowiak RSJ
  35. Ann Neurol v.31 Funtional reorganization of the brain in recovery from striatocapsular infarction in man Weiller C;Chollet F;Friston KJ;Wise RSJ;Frackowiak RSJ
  36. Stroke v.30 Reorganization of sensory and motor systems in hemiplegic stroke patients: A positron emission tomography study Nelles G;Spiekermann G;Jueptner M;Leonhardt G;Iler S;Gerhard H;Diener HC
  37. Annu Rev Pharmacol Toxicol v.22 Neurochemical basis of acupuncture analgesia Han JS;Terenius L
  38. Neurosci Lett. v.97 Acupuncture and sensory neuropeptides increase cutaneous blood flow in rats Jansen G;Lundeberg T;Kjartansson S;Samuelson UE
  39. Brain Res v.666 no.1 Effects of electroacupuncture and physical exercise on regional concentrations of neuropeptides in rat brain Bucinskaite V;Lundeberg T;Stenfors C;Ekbom A;Dahlin L;Theodorsson E
  40. Stroke v.25 Sensory stimulation promotes normalization of postural control after stroke Magnusson M;Johansson K;Johansson BB