| 谭新,陈璇君,古小辉,等.针刺肌筋膜触发点对脑卒中后下肢痉挛患者步行功能的影响[J].中华物理医学与康复杂志,2026,48(8):696-702 |
| 针刺肌筋膜触发点对脑卒中后下肢痉挛患者步行功能的影响 |
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| DOI：10.3760/cma.j.cn421666-20250730-00645 |
| 中文关键词: 肌筋膜触发点 脑卒中 下肢肌痉挛 步行参数 关节活动度 |
| 英文关键词: Myofascial trigger points Stroke Muscle spasticity of lower limb Spatiotemporal gait parameters Joint angle |
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| 目的 探究针刺肌筋膜触发点（MTrPs）对脑卒中后下肢肌痉挛患者下肢步行参数和关节活动度的影响。 方法 选择2022年12月至2024年12月期间在本院接受治疗的100例脑卒中后下肢肌痉挛患者作为研究对象，采用随机数字分组法分为试验组（针刺MTrPs联合常规针刺疗法）和对照组（常规针刺疗法），每组50例患者。利用广义估计方程（GEE）方法对2组患者不同时间点临床痉挛指数（CSI）、Fugl-Meyer运动功能评定量表（FMA）评分和Berg平衡量表（BBS）评分进行对比。 结果 与治疗前相比，2组患者的FMA、BBS评分、步态参数（步幅、步频、步速）和关节活动度（髋关节屈伸范围、膝关节屈伸范围和踝关节屈伸范围）随治疗疗程呈上升趋势，而CSI评分、双支撑相和患侧支撑相呈下降趋势 （P<0.05）。组间比较显示，治疗1个及3个疗程后，试验组在运动功能（FMA、BBS）、步态时空参数及关节活动度方面的改善幅度均显著优于对照组（P<0.05）；治疗1个及3个疗程后试验组的CSI评分及双支撑相、患侧支撑相占比均显著低于对照组（P<0.05）。试验组治疗总有效率高于对照组（P<0.05）。 结论 针刺MTrPs联合常规针刺疗法临床疗效优于常规针刺疗法，联合治疗可进一步改善脑卒中后下肢肌痉挛患者的痉挛程度，提高步幅、步频、步速及关节活动度。 |
| 英文摘要: |
| Objective To investigate the effects of acupuncture at myofascial trigger points (MTrPs) on spatiotemporal gait parameters and lower limb joint angles during walking in stroke patients with post-stroke lower limb muscle spasticity. Methods A total of 100 stroke patients treated at our hospital between December 2022 and December 2024 were enrolled and randomly assigned to either an experimental group (conventional acupuncture combined with MTrPs stimulation, n=50) or a control group (conventional acupuncture alone, n=50). The Generalized Estimating Equation (GEE) method was employed to compare the Clinical Spasticity Index (CSI), Fugl-Meyer Assessment (FMA) scores, and Berg Balance Scale (BBS) scores between the two groups at different time points. Furthermore, linear regression analysis was conducted to examine the correlation between lower limb spatiotemporal parameters (stride length, gait speed, cadence, single-limb support phase on the affected side, and double support phase) and joint range of motion (ROM) (flexion and extension ranges of the hip, knee, and ankle joints). Results Compared with baseline values, both groups exhibited significant improvements over the course of treatment, characterized by increased FMA and BBS scores, optimized spatiotemporal parameters (stride length, cadence, gait speed), and enhanced joint ROM (hip, knee, and ankle flexion/extension). Conversely, CSI scores, the double support phase, and the affected-side support phase showed a decreasing trend (P<0.05). Inter-group comparisons revealed that after 1 and 3 courses of treatment, the experimental group demonstrated significantly greater improvements in motor function (FMA, BBS), spatiotemporal gait parameters, and joint ROM compared to the control group (P<0.05). Additionally, the experimental group showed significantly lower CSI scores and reduced proportions of double support and affected-side support phases than the control group (P<0.05). Moreover, the total effective rate was significantly higher in the experimental group than in the control group (P<0.05). Conclusion Acupuncture at MTrPs combined with conventional acupuncture yields superior clinical efficacy compared to conventional acupuncture alone. This combined therapy effectively alleviates muscle spasticity and significantly improves spatiotemporal gait parameters, including stride length, cadence, and gait speed, as well as lower limb joint mobility in patients with post-stroke lower limb spasticity. |
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