康复学报 (Apr 2022)
Effect of Cluster Needling of Scalp Acupuncture Combined with Walking Training on Walking Ability of Stroke Patients under Different Task
Abstract
ObjectiveTo observe the effect of cluster needling of scalp acupuncture combined with walking training on walking ability of stroke patients under single-task walking (STW) and dual-task walking (DTW) paradigm.MethodsA total of 78 inpatients with non-acute stroke who were treated in the the Third Affiliated Hospital of Zhejiang Chinese Medicine University from September 2019 to April 2021, which were divided into the control group and the observation group according to the random number table method, with 39 cases in each group. Both groups received conventional treatment for cerebrovascular disease, the control group received walking training on the basis of conventional treatment, 40 minutes a time, once a day, five days a week, continuous treatment for four weeks, including antigravity muscle training, lower limb weight-bearing support training, lower limb step training of affect side and standing center of gravity transfer training, etc. The observation group received cluster needling of scalp acupuncture on the basis of the control group, once a day, five days a week, continuous treatment for four weeks. The parietal area, anterior parietal area and frontal area of the head were selected for cluster needling of scalp acupuncture, the needles were kept for six hours, routine walking training was performed during needle retention. Before and after treatment, the gait parameters (stride, step length, step speed, stride frequency, stride time, support time, swing time) under STW and DTW paradigms were evaluated by the gait detection evaluation and training system; activities of daily living (ADL) were used to assess patients' activities of daily living, including basic activities of daily living (BADL) and instrumental activities of daily living (IADL).Results① Gait parameters: compared with the STW paradigm, stride, step length, stride speed, stride frequency and swing time of the stroke patients were significantly decreased under the DTW paradigm, while stride time and support time were significantly increased, the differences were statistically significant (P<0.05). Under the STW and DTW paradigm, compared with before treatment, stride,step length, step speed, stride frequency and swing time of the two groups after treatment were significantly increased (P<0.05), while stride time and support time were significantly decreased (P<0.05). Under the STW paradigm, compared with the control group, the stride,step length, step speed, stride frequency and support time of the observation group were significantly increased (P<0.05), and the stride time was significantly decreased (P<0.05). Under the DTW paradigm, compared with the control group, stride,step length, step speed, stride frequency of the observation group were significantly increased, while the stride time was significantly decreased (P<0.05). ② ADL scores: compared with before treatment, the ADL total score and BADL score of the two groups after treatment were significantly decreased, and the IADL score in the observation group after treatment was significantly decreased (P<0.05). Compared with the control group, the ADL total score and IADL score in the observation group were significantly decreased (P<0.05).ConclusionThe walking ability of stroke patients with dual-task walking is lower than that of single-task walking; cluster needling of scalp acupuncture combined with walking training can effectively improve the walking ability of dual-task and activities of daily living.
