電針炙治療慢性腦中風之初步報告

Application of electroacupuncture for Improving Gait Performance of Stroke Patient

魏大森(Dah-Sen Weih) ； 楊百嘉(Baii-Jia Yang)

《中華民國復健醫學會雜誌》 20期 (1992/12) Pp. 61-67

https://doi.org/10.6315/JRMA.199212.0007

摘要

痙攣性足內翻是腦中風患者步態障礙常見的原因，其對病人安全及日常活動功能影響甚鉅。由於中風病人發病後大於六個月者經復健治療仍常見足內翻，本研究嘗試使用穴位電針療法來改善病人步態，並探討各種因素如足部痙攣性、關節活動度、步行速率、跨步時問、跨步長度、步幅寬度等之改變。本研究篩選22位病人，計14位完成為期四週之治療計劃，共中男性9人，女性5人，年齡由38歲至71歲，患病期間由6個月至28個月。病人每天（次）給予25分鐘電針刺激，位置為陽陵泉及腓骨肌肌腹中點，一星期治療5天，開始治療前、治療兩週、治療四週及治療結束後一個月分別作評估：以Modified Ashworth Scale測定小腿後肌痙攣性程度，Cybex EDI 320 electronic inclinometer評估踝關節之主動活動角度，blue carbon paper method簡要測定病人之步幅寬度，並以定距離（30公尺）行走來計算病人步行速率及步式周期時間。結果顯示：治療期間病人足部痙攣度有減低現象，治療停止後則多恢復至先前狀態：關節活動度、步行速率、跨步時間、步幅寬度、跨步長度等在療程結束時亦有顯著之進步，於追蹤評估時仍具有一定之療效。以上結果顯示：電針灸療法可做為發病後六個月以上腦中風病人復健之有效輔助療法。

關鍵字

腦中風 ； 痙攣性肉翻足 ； 電針炙

並列摘要

Spastic equinovarus foot, a major cause of gait disturbance in stroke patients, impairs patients' safety and interferes with the activities of daily living. Even after rehabilitation training, equinovarus foot is not uncommon in stroke patients with disease duration more than 6 months, we use electroacupuncture to improve gait performance.
This report is a discussion of the changes and correlation among various factors that may influence gait performance, such as ankle spasticity, range of motion of ankle, walking velocity, gait cycle duration, stride length and stride width.
24 patients began, but only 14 patients completed the 4-week therapeutic schedule (9 males and 5 females, 38 to 71 years old, time after onset 6 to 28 months). Electric stimulation was performed over GB34 and midperoneal muscle of affected limb for 25 minutes, 5 times per week. We assessed the patients before therapy, 2 weeks after therapy, at the end of therapy and one month after the end of therapy respectively. Modified Ash-worth scale was used for evaluating ankle spasticity, Cybex EDI 320 electronic inclinometer for range of motion of ankle, blue carbon paper method for stride length, and 30 meters walking for walking velocity and gait cycle duration.
The results revealed that ankle spasticity significantly decreased during period of therapy, but most patients returned to initial state at follow-up; range of motion of ankle, walking velocity, gait cycle duration, stride width and stride length were also significantly improved at the end of therapy but with varying degree of improvement loss at follow-up. In summary, electroacupuncture could act as a valuable assistive tool of rehabilitation in stroke patient with disease duration more than 6 months.