Objectives: To investigate the effects of electroacupuncture (EA) at Juliao (GB29) on lower limb motor function, balance function, and the gluteus medius contraction ratio and thickness in patients with stroke-related hemiplegia, as well as the correlation between the gluteus medius and lower limb motor function and balance function in these patients.
Methods: A total of 68 patients with stroke-related hemiplegia were randomly divided into an observation group (34 cases, with 1 dropped out and 1 withdrawal) and a control group (34 cases, with 2 dropped out). The control group received conventional acupuncture in addition to standard medical treatment for their underlying conditions, along with rehabilitation training. The observation group received EA at GB29 on the hemiplegic side for 30 min per session, once daily, 5 times a week, over a total treatment duration of 4 weeks, based on the control group's treatment. Before treatment, the correlation between the contraction ratio of the gluteus medius and the scores of the lower limb Fugl-Meyer Assessment (FMA) and the Berg Balance Scale (BBS) was analyzed. The thickness of the gluteus medius was measured, and the contraction ratio was calculated before treatment and 4 weeks after treatment. Assessments of the lower limb FMA and BBS scores were conducted before treatment, and 2 and 4 weeks after treatment.
Results: Before treatment, the contraction ratio and thickness of the gluteus medius on the hemiplegic side were lower than those on the non-hemiplegic side in both groups (P<0.05). The gluteus medius contraction ratio before treatment demonstrated a positive correlation with the lower limb FMA and BBS scores (P<0.05). The gluteus medius contraction ratio and thickness on the hemiplegic side 4 weeks after treatment, as well as the lower limb FMA and BBS scores 2 and 4 weeks after treatment, were significantly higher than those before treatment in both groups (P<0.05). Furthermore, the observation group showed a greater contraction ratio of the gluteus medius, as well as higher FMA and BBS scores 4 weeks after treatment when compared with the control group (P<0.05).
Conclusions: The level of gluteus medius activation is positively correlated with lower limb motor function and balance function in patients with stroke-related hemiplegia. EA at the GB29 effectively activates the gluteus medius on the hemiplegic side, providing a stability mechanism for the lumbopelvic-hip complex, thereby improving lower limb motor function and balance in patients with stroke.
目的: 观察电针居髎对中风偏瘫患者臀中肌收缩比、臀中肌厚度的影响及其对下肢运动功能及平衡功能恢复的影响，探究臀中肌与中风偏瘫患者下肢运动功能和平衡功能的相关性。方法: 将中风偏瘫患者随机分为观察组（34例，脱落1例，退出1例）和对照组（34例，脱落2例）。对照组在内科疾病常规治疗基础上配合常规针刺（偏瘫侧上肢取穴肩髃、曲池、手三里、合谷，偏瘫侧下肢取穴足三里、阳陵泉、太冲、丘墟）及康复训练；观察组在对照组基础上予电针偏瘫侧居髎，每次30 min，1次/d，每周5次，共治疗4周。在治疗前分析臀中肌收缩比与下肢Fugl-Meyer运动功能评定量表（FMA）、Berg平衡量表（BBS）评分的相关性；在治疗前、治疗第4周后进行臀中肌厚度的测量，计算收缩比；治疗前、治疗第2周、治疗第4周后对下肢FMA、BBS评分进行评估。结果: 治疗前两组患者偏瘫侧臀中肌收缩比、臀中肌厚度低于非偏瘫侧（P<0.05）；治疗前臀中肌收缩比与下肢FMA、BBS评分呈正相关（P<0.05）。治疗4周后两组患者的偏瘫侧臀中肌收缩比、偏瘫侧臀中肌厚度，治疗2周和4周后FMA评分、BBS评分均较治疗前升高（P<0.05），且治疗4周后除臀中肌厚度外，其余指标观察组均高于对照组（P<0.05）。结论: 臀中肌激活程度与中风偏瘫患者下肢运动功能、平衡功能呈正相关；电针偏瘫侧居髎能有效激活偏瘫侧臀中肌，为腰盆髋关节复合体提供稳定性机制，改善中风患者的下肢运动功能及平衡功能。.
Keywords: Electroacupuncture; Gluteus medius; Juliao (GB29); Lower limb motor function; Musculoskeletal ultrasound.