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Sensory changes, C-and A-fiber function, and shoulder-hand syndrome in hemiplegic patients after stroke

Neural Regeneration Research 2008年第7期3卷 760-763页

作者： Yi Yuan Xiaohong Zi Xian Huang Department of Neurology the Third Xiangya Hospital Central South University Changsha 410013 Hunan Province China

BACKGROUND： Clinical diagnosis of various neurological disorders involving the sensory nerves depends primarily on subjective description, which cannot be quantitatively evaluated, and is also less reproducible and specific. Quantitative sensory testing methods can overcome these shortcomings and is currently used to identify the function of the C- and A-fibers. OBJECTIVE： To apply the quantitative sensory testing method for analyzing changes in temperature sensation, cryalgesia, thermalgesia, and vibration sense on the skin surface of hemiplegic patients with post-stroke shoulder-hand syndrome, and to analyze the relationship between these changes and shoulder-hand syndrome. DESIGN, TIME AND SETTING： A non-randomized, concurrent, control study was performed at the Clinic and Inpatient Department of the Third Xiangya Hospital, Central South University, between June 2000 and April 2001. PARTICIPANTS： Thirty post-stroke, hemiplegic patients were divided into shoulder-hand syndrome and control groups, according to whether patients exhibited shoulder-hand syndrome, with 15 patients in each group. METHODS： A TSA2001 quantitative sensory testing device （Medoc, Israel） was used for quantitative sensory testing. All sensory testing employed limits, testing temperature sense on the palm thenar eminence and vibration sense on the thumb metacarpal. Cold threshold was ≤ 28 ℃, warmth threshold was ≥ 36 ℃, cold-evoked pain threshold was ≤ 5 ℃, heat-evoked pain threshold was ≥ 51 ℃, vibration threshold was ≥ 5 μm/s; if a patient met one of these items, he/she was considered to be hypoanesthesia. MAIN OUTCOME MEASURES： Cold, warm, cold-evoked pain, heat-evoked pain and vibration threshold changes on skin from the paralyzed upper extremity was measured in the shoulder-hand syndrome and control groups. RESULTS： Incidence of sensory disability in the shoulder-hand syndrome group increased more significantly than in the control group （P 〈 0.05）, with the primary manifestati

关键词： shoulder-hand syndrome stroke quantitative sensory testing

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Therapeutic effect of acupuncture and massage for shoulder-hand syndrome in hemiplegia patients:a clinical two-center randomized controlled trial

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Journal of Traditional Chinese Medicine 2012年第3期32卷 343-349页

作者： Ning Li Fengwei Tian Chengwei Wang Pengming Yu Xi Zhou Qian Wen Xiulan Qiao Lu Huang Acupuncture Department of Huaxi Hospital Affiliated to Sichuan University Chengdu 610041 China Acupuncture Department of Chongqing Municipal TCM Hospital Chongqing400021 China Rehabilitation Department of Huaxi HospitalAffiliated to Sichuan University Chengdu 610041 China

OBJECTIVE:To evaluate the therapeutic effects of acupuncture and massage for shoulder-hand syndrome in hemiplegia ***:One hundred and twenty hemiplegia patients with stage I shoulder-hand syndrome were randomly divided into a group treated with standardized electric acupuncture and massage,and a group treated with rehabilitation therapy for 6 *** primary indices evaluated were pain on passive movement of the shoulder using the numeric pain rating scale(NPRS),and the number of patients with shoulder-hand syndrome at Steinbrocker stage II or III after *** secondary indices were Fugl-Meyer evaluation of functional movement of the upper limb and hand using the modified rankin scale(MRS).RESULTS:At post-treatment evaluation and a 12-week follow-up visit,NPRS score,number of patients with stage II or III shoulder-hand syndrome,and MRS score were all improved in the acupuncture-massage group compared with the rehabilitation group(Pshoulder-hand syndrome in hemiplegia patients.

关键词： Rehabilitation by acupuncture or moxibustion Rehabilitation by tuina Stroke Hemiplegia shoulder-hand syndrome

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Treatment of 40 Cases of Poststroke shoulder-hand syndrome by Acupuncture

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Journal of Acupuncture and Tuina Science 2008年第1期6卷 17-18页

作者：程小平肖元春 Department of Acupuncture Affiliated Hospital of Yan'an UniversityShannxi 716000P.R.China

Acupuncture and rehabilitation therapies were used to treat 40 cases of shoulder-hand syndrome, the results show that integration of acupuncture and rehabilitation can increase therapeutic effects and shorten treatmen... 详细信息

关键词： Poststroke syndrome Cerebrovascular Disorder shoulder-hand syndrome Acupuncture Therapy Rehabilitation Reflex Sympathetic Dystrophy

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Muscle regions of meridians warm needling method plus pricking Jing-Well points for blood-letting in the treatment of shoulder-hand syndrome after stroke

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Journal of Acupuncture and Tuina Science 2021年第4期19卷 291-299页

作者： Tang Xiao-li Pan Hai-yan Rehabilitation Medicine Department Kaizhou District People's HospitalChongqing MunicipalityChongqing 405400China

Objective To observe the effect of muscle regions of meridians warm needling method plus pricking Jing-Well points for blood-letting in improving nail fold microcirculation in the patients with shoulder-hand syndrome(SHS)after stroke,and the effects on hemorrheology,calcitonin gene-related peptide(CGRP)and serum substance P(SP).Methods A total of 72 patients were randomized into an observation group and a control group by the random number table method,with 36 cases in each *** control group was treated with physical rehabilitation training,and the observation group was treated with additional muscle regions of meridians warm needling method plus pricking Jing-Well points for blood-letting *** treatment course lasted for 4 *** treatment,the clinical efficacy of the two groups was *** changes in shoulder-hand syndrome scale(SHSS),simplified Fugl-Meyer assessment-upper extremity(FMA-UE),visual analog scale(VAS),activities of daily living(ADL),traditional Chinese medicine(TCM)syndrome score,nail fold microcirculation hemorheology indictors[whole blood viscosity(high-shear,low-shear),hematocrit,erythrocyte sedimentation rate(ESR)],CGRP and SP levels were *** The total effective rate in the observation group was 86.1%,higher than 63.9%in the control group(Psyndrome in both groups decreased significantly(all Psyndrome in the observation group were lower than those in the control group(both P<0.05),and the scores of F

关键词： Acupuncture Therapy Warm Needling Therapy Acupuncture-moxibustion Therapy Pricking Therapy Points,Jing-Well(Five Shu-Transmitting) Poststroke syndrome shoulder-hand syndrome Blood Circulation

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Timeliness of the analgesic effect of superficial needling on shoulder-hand syndrome after stroke

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World Journal of Acupuncture-Moxibustion 2015年第4期25卷 5-10页

作者：汪军崔晓裴建倪欢欢周翠侠黄春水黄美瞿佩玉董英上海市长宁区天山中医医院康复科上海中医药大学附属龙华医院针灸科上海中医药大学预防教研室

Objective To observe the correlation between analgesic effect and duration of analgesic effect of superficial needling for shoulder pain of shoulderhand syndrome（SHS） after stroke, so as to screen the best time period of analgesia. Methods A total of 120 patients with SHS after stroke（stage I） were recruited and superficial needling therapy was applied. Two obvious tenderness points on the affected shoulder of patients were found out. The site 80–100 mm down each tenderness point was selected for superficial needling. Bimanual needling technique was applied after inserting needles. The surrounding of tenderness points was pinched and grasped by left hand above the needling, and the technique of green dragon swaying tail was applied by right hand. The needles at each acupoint were manipulated for3 min and retained for 30 min. The analgesic effect was evaluated dynamically by visual analogue scale（VAS） in 120 patients before treatment, immediately after treatment, 30 min after treatment, 1 h after treatment and 24 h after treatment. The analgesic effects at different time were statistically analyzed by generalized estimating equation. Results The mean values of VAS were 7.483, 3.950, 4.767, 5.917 and 7.217, respectively, before treatment, immediately after treatment, 30 min after treatment, 1 h after treatment and 24 h after treatment. The difference of analgesic effect at different time was statistically significant（P〈0.01）; the difference of analgesic effect of superficial needling in treatment of SHS after stroke was significant between immediately after treatment and 30 min after treatment（both P〈0.05）, while there was no significant difference between 1 h after treatment and 24 h after treatment（both P〈0.05）. Conclusion Analgesic effect of superficial needling for shoulder pain of SHS after stroke was different at different time points and decreased over time; analgesic effect was the most significant immediately after treatment and the optimal duration of analge

关键词： shoulder-hand syndrome stroke shoulder pain superficial needling VAS score acupuncture analgesia timeliness research

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Clinical Research of Traditional Chinese Medicine Fumigation and Washing Combined with Rehabilitation Training in the Treatment of Post-Apoplexy shoulder-hand syndrome

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World Journal of Integrated Traditional and Western Medicine 2021年第6期7卷 52-57页

作者： XIE Ya-qing MAO Zhong-nan ZHANG Xiao-ling WANG Rui-rui College of Acupuncture Moxibustion and TuinaGansu University of Traditional Chinese MedicineLanzhou 730000China Affiliated Hospital of Gansu University of Traditional Chinese Medicine Lanzhou730000China

Objective:To observe the clinical effect of traditional Chinese medicine fumigation and washing combined with routine rehabilitation training on post-stroke shoulder and hand syndrome(SHS).Comparing and analysing the effects of this treatment on the living ability of patients with post-stroke shoulder and hand ***:Fifty patients with post-stroke SHS who met the inclusion criteria were divided into observation group and control group by random number table method with 25 cases in each *** groups were given post-stroke secondary prophylactic drugs,while the control group was given routine rehabilitation training,20-30 minutes at a time,once a day,5 days a week,4 weeks as a course of *** the basis of treatment in the control group,the observation group was combined with traditional Chinese medicine fumigation and washing,decocted with water to extract 3,000-4,000 ml juice,and added into the medicine bath bucket to soak the affected limb for 30-40 minutes,once a day,5 days a week,4 weeks as a course of *** changes of upper limb edema degree,Numeric Rating Scale(NRS)score,Barthel index(MBI)and Fugl-Meyer Rating(FMA)scores before and after treatment were observed between the two groups,and the differences of clinical efficacy between the two groups were ***:After treatment,the total effective rate in observation group was significantly better than that in control group(P<0.05).After treatment,the degree in upper limb edema in the two groups was significantly reduced(P<0.05),NRS score was decreased(P<0.05).Barthel index and FMA score were significantly increased(P<0.05),and the degree of upper limb edema and NRS score in the observation group were significantly lower than those in the control group(P<0.05).Barthel index and FMA score were significantly higher than those in the control group(P<0.05).Conclusion:The combination of traditional Chinese medicine fuming and washing with rehabilitation training has a better thera

关键词： Traditional Chinese medicine fumigation Rehabilitation training shoulder-hand syndrome Post-apoplexy

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Delphi and Analytic hierarchy process for the construction of a risk assessment index system for post-stroke shoulder-hand syndrome

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Nursing Communications 2022年第1期6卷 1-6页

作者： Yu-Huan Zhang Chun-Bo Fan Yong-Mei Luo Dong Chen Chun-Xiao Yang Dong Pang Department of Neurology The Second Hospital of Harbin Medical UniversityHeilongjiang150001China Department of Neurology Peking University Third HospitalBeijing100191China

Background:shoulder-hand syndrome(SHS)is one of the common complications after stroke,which is difficult to cure once it *** risk identification is an effective measure to prevent and treat SHS,but there is no effective tool to assess the risk assessment of ***:To develop a validated tool to assess the risk of SHS occurrence after ***:This was an observational study with a 3-step process:(1)Literature review to establish initial indicators;(2)Application of a modified Delphi method for two rounds of correspondence,with final indicators obtained by modifying each round based on expert opinion;(3)Application of hierarchical analysis to determine the weights of each ***:The initial literature review constructed4 primary indicators and 24 secondary indicators;after the first round of Delphi,a total of 10 secondary indicators were deleted and 6 secondary indicators were added,and the final indicators included 3 primary indicators and 15 secondary indicators,and in the second round,consensus was reached;by AHP analysis,the highest weight was given to existing risk factors(0.5584),followed by relevant medical history(0.3196);lastly,demographic factors(0.1220),and the scores of other secondary indicators met the ***:This study establishes and constructs a post-stroke SHS risk assessment tool,which provides a basis for early identification of SHS and early ***,this study provides a methodological reference for the development of other indicatorssets.

关键词： Analytic hierarchy process Delphi method Stroke patients shoulder-hand syndrome shoulder-hand syndrome Risk assessment

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Clinical Observation on Electroacupuncture Treatment of shoulder-hand syndrome in Apoplectic Hemiplegia

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Journal of Acupuncture and Tuina Science 2006年第6期4卷 347-349页

作者：魏向阳徐瑶 Department of Physiotherapy First Hospital Affiliated to Zhengzhou University

Objective： To investigate the therapeutic effect of electroacupuncture on shoulder-hand syndrome in apoplectic hemiplegia. Methods： One hundred and sixty patients were randomly divided into two groups. 80 cases in the control group was treated by conventional acupuncture by filiform needles and 80 cases in the treatment group were treated by electroacupuncture. The therapeutic effects were evaluated after two courses of treatment. Results： After two courses of treatment, the therapeutic effect for edema on back of the hand and hand pain in digital flexion and the total effective rate were better in the treatment group than in the control group （P〈0.05）. Conclusion： Electroacupuncture is of significant importance for relieving pain on back of hand, preventing the muscular atrophy of hand and promoting recovery from apoplexy.

关键词： Electroacupuncture Wind Stroke shoulder-hand syndrome

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Effect of kinetic needling combined with blood-letting puncturing and cupping on functions of upper limbs of patients with shoulder-hand syndrome after apoplexy

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World Journal of Acupuncture-Moxibustion 2010年第1期20卷 7-12,23页

作者：刘未艾吴清明付磊李向荣李丹丹湖南中医药大学第二附属医院针灸-中风专科

Objective To observe influence of kinetic needling on functional restoration of upper limbs of patients with apoplexy-induced shoulder-hand syndrome. Methods Ninety patients were randomly divided into an observation group （45 cases） and a control group （45 cases）. Basic treatments selected according to corresponding stroke units were applied to both groups. Besides, scalp acupuncture at Dingnie Qianxiexian （MS 6, 顶颞前斜线）, Dingnie Houxiexian （MS 6, 顶颞前斜线） and Dingzhongxian （NS 5, 顶中线）, was applied in the treatment group. In the observation group, active and passive movement was carried out during the process of scalp acupuncture, and then needling plus bloodletting puncturing and cupping was applied. In the control group, only needling plus blood-letting puncturing and cupping was given. Therapeutic effects, pain scoring obtained by visual analogue scales （VAS）, FugI-Meyer and FugI-Meyer＇s scoring reflecting moving functions of upper limbs were made after 4 courses of treatments in both groups. Results The total effective rate was 95.5% and 91.1% in the observation group and control group, respectively, showing superiority of the former to the latter （P〈0.05）. After treatment, VAS scores were all obviously reduced in both groups （P〈0.01）, and the reduction in the former was significantly more than that in the latter （P〈0.01）. Moving functions of upper limbs shown by Fugl-Meyer＇s scoring were improved after 2 courses of treatment in both groups （P〈0.01）. The improvement was more obvious after 4 courses of treatment than that after 2 courses of treatment in both groups （P〈0.05）. After 4 courses of treatment, moving functions shown by FugI-Meyer＇s scoring were more remarkably improved in the observation group than those in the control group（t=3.9, P〈0.01）. Conclusion Both kinetic needling combined with needling plus blood-letting puncturing and cupping and simple needling plus blood-letting puncturing and cupping are effective in treating shoulder-hand syndrome after apo

关键词： Apoplexy shoulder-hand syndrome Kinetic Needling Blood-letting Puncturing and Cupping (B-IPC)

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