RESUMO
The withdrawal reflex is a defensive reaction to nociceptive stimuli and can be used to regulate locomotor gait during rehabilitation. We investigated the effect of successive needle-pricking of the plantar and dorsal foot surfaces on poststroke lower limb function. Thirty-five hemiplegic patients, within one month after primary stroke, with an affected lower limb (Brunnstrom stage III) were randomly divided into intervention and control groups. Both groups received routine drug treatment, rehabilitation training, and upper limb acupuncture treatment on the hemiplegic side. The control group also received routine acupuncture on the hemiplegic side of the lower limb, while the intervention group received successive needle-pricking on the sole and instep of both the unaffected and affected side feet. Outcomes were assessed before inception (D0) and after three (D3) and six (D6) treatment days, using Brunnstrom stage (Ueda assessment), total Fugl-Meyer lower extremity assessment (FMA-LE) and its subscores (FMA-LE-ss), active lower limb range of motion (AROM-LL), Modified Ashworth Scale Score (MAS-LL), and manual muscle testing (MMT-LL). The Brunnstrom stage was better in the intervention group than in the control group at both D3 and D6 (P < 0.01). The total FMA-LE score and sections B, C, D, and G FMA-LE-ss were significantly better in the intervention group than in the control group at D3 and D6 (P < 0.05). The AROM-LL hip and knee flexion and hip extension improved more in the intervention group than in the control group (P < 0.05). In the intervention group, MAS-LL hip flexion significantly improved at D6 (P < 0.01). Improvement in lower limb joints on the MMT-LL in the intervention group exceeded that in the control group at D6 (P < 0.01). Successive needle-pricking on the plantar and dorsal foot aspects of Brunnstrom stage III in poststroke patients contributed to rapid lower limb motor function improvement via the withdrawal reflex. This trial is registered with ChiCTR1900020633.
RESUMO
BACKGROUND: Posttraumatic epilepsy (PTE) is a common complication of traumatic brain injury (TBI), which seriously affects patients' survival and recovery. Vagus nerve stimulation (VNS) is a nonpharmacological therapy for epilepsy. The auricular branch of the vagus nerve (ABVN) is the only peripheral branch and has antiepileptic effects, but the efficacy of ABVN stimulation as treatment of late PTE is uncertain. We retrospectively analyzed the clinical efficacy of ABVN stimulation by auricular electroacupuncture for the treatment of late PTE, and investigated the influence of sodium valproate and edaravone on the anti-PTE effects of auricular electroacupuncture. METHOD: Univariate and multivariate logistic regression analyses were used to investigate the relationship of age, cause of PTE, use of auricular electroacupuncture, sodium valproate, and edaravone with the incidence of late PTE. To compare the curative effects of auricular electroacupuncture, 89 cases of late PTE were divided into an auricular electroacupuncture and a control group according to whether they were treated with auricular electroacupuncture. We further analyzed the influence of sodium valproate and edaravone on the effects of the treatment of PTE with auricular electroacupuncture. RESULTS: Among age, cause, use of auricular electroacupuncture, sodium valproate, and edaravone, the use of auricular electroacupuncture was associated with significantly reduced incidence of late PTE (P < 0.05). Compared with the control group, there were more seizure-free cases in the auricular electroacupuncture group (P < 0.01). The total effective rate of the auricular electroacupuncture group was 90%. The seizure-free rate among patients treated with auricular electroacupuncture was significantly reduced, regardless of the use of sodium valproate or edaravone (P < 0.05). CONCLUSION: Auricular electroacupuncture can reduce the incidence of late PTE and is a safe and economical therapy for late PTE.