Volume 22 Issue 2
Feb.  2024
Turn off MathJax
Article Contents
Article Navigation >  Chinese Journal of General Practice  > 2024  >  22(2): 304-307
WANG Huanfen, LIU Wei, CHEN Saiya, CHEN Meilan. Study on the treatment of lower limb muscle spasms after stroke using botulinum toxin A injection combined with spasmodic electromyography stimulation[J]. Chinese Journal of General Practice, 2024, 22(2): 304-307. doi: 10.16766/j.cnki.issn.1674-4152.003390
Citation: WANG Huanfen, LIU Wei, CHEN Saiya, CHEN Meilan. Study on the treatment of lower limb muscle spasms after stroke using botulinum toxin A injection combined with spasmodic electromyography stimulation[J]. Chinese Journal of General Practice, 2024, 22(2): 304-307. doi: 10.16766/j.cnki.issn.1674-4152.003390
shu

Study on the treatment of lower limb muscle spasms after stroke using botulinum toxin A injection combined with spasmodic electromyography stimulation

doi: 10.16766/j.cnki.issn.1674-4152.003390

  • Department of Geriatrics, Wenzhou Traditional Chinese Medicine Hospital, Wenzhou, Zhejiang 325000, China

Funds:

 2023KY1159

  • Received Date: 2023-10-12
    Available Online: 2024-03-27
    Abstract
  •   Objective  To enhance the treatment options for post-stroke muscle spasms and improve the quality of life of stroke patients, the clinical effect of combining botulinum toxin A injection with spasmodic electromyography stimulation for the rehabilitation of post-stroke lower limb muscle spasms were explored.  Methods  A total of 140 patients with lower limb muscle spasms after stroke who were admitted to Wenzhou Traditional Chinese Medicine Hospital between February 2020 and February 2023 were enrolled. The 70 cases in the observation group and the 70 cases in the control group were randomly divided into two groups using a random number table method. All patients underwent rehabilitation training, The control group received injection of type A botulinum toxin, while the observation group received additional treatment with spasmodic electromyographic stimulation. The study evaluated the therapeutic effect of interventions on lower limb muscle spasms in patients, comparing the levels before and after the intervention. The lower limb muscle ' s motor unit action potential (MUAP) count was measured. The study evaluated the level of motor function and living ability, as well as changes in ultrasonic indexes of gastrocnemius muscle structure.  Results  The research group achieved a significantly higher overall effective rate of lower limb muscle spasm treatment (94.29%, 66/70) compared to the control group (81.43%, 57/70), χ2=5.423, P=0.020. Following the intervention, the number of MUAP in the triceps surae of the observation group (10.92±1.74) was significantly lower than that of the control group (14.86±1.85, t=12.979, P < 0.001). Following the intervention, the scores for Fugl-Meyer assessment scale (FMA), functional ambulation category scale (FAC), and modified Barthel index (MBI) were significantly higher in the observation group than in the control group (P < 0.001). Following the intervention, the observation group exhibited lower PA and MT values of in the lower limb gastrocnemius muscle compared to the control group. Conversely, the FL and MT values were higher in the observation group than in the control group (P < 0.001).  Conclusion  The combination of spastic myoelectric stimulation and botulinum toxin A therapy can enhance the therapeutic effect of lower limb muscle spasms after stroke. It can also alleviate the severity of lower limb muscle spasms, promote the recovery of affected limb muscle structure and function, and improve patients ' motor ability and quality of life.

     

    • FullText(HTML)
  • loading
    • References(20)
  • [1]
    田立茹, 王鹏琴, 邵妍, 等. 眼针带针康复疗法治疗脑卒中后下肢痉挛的临床疗效及表面肌电特征研究[J]. 中华中医药杂志, 2022, 37(11): 6855-6859. https://www.cnki.com.cn/Article/CJFDTOTAL-BXYY202211132.htm

    TIAN L R, WANG P Q, SHAO Y, et al. Clinical effects of eye-acupuncture with rehabilitation in stroke patients with lower limb spasticity and its character of sEMG[J]. China Journal of Traditional Chinese Medicine and Pharmacy, 2022, 37(11): 6855-6859. https://www.cnki.com.cn/Article/CJFDTOTAL-BXYY202211132.htm
    [2]
    姜玉莹, 邢红霞, 贾涵, 等. 头针联合放散式体外冲击波对脑卒中后下肢痉挛的疗效观察[J]. 中国老年保健医学, 2022, 20(5): 70-74. https://www.cnki.com.cn/Article/CJFDTOTAL-LNBJ202205018.htm

    JIANG Y Y, XING H X, JIA H, et al. Therapeutic effect of scalp acupuncture combined with radial extracorporeal shock wave on lower limb spasm after stroke[J]. Chinese Journal of Geriatric Care, 2022, 20(5): 70-74. https://www.cnki.com.cn/Article/CJFDTOTAL-LNBJ202205018.htm
    [3]
    王腾, 孟海超, 王正田, 等. 冲击波联合下肢负重振动训练治疗脑卒中后下肢肌痉挛的疗效观察[J]. 河北医学, 2022, 28(12): 2072-2077. https://www.cnki.com.cn/Article/CJFDTOTAL-HCYX202212026.htm

    WANG T, MENG H C, WANG Z T, et al. The efficacy of shock wave combined with lower limb weight-bearing vibration training in the treatment of lower limb muscle spasm after stroke[J]. Hebei Medicine, 2022, 28(12): 2072-2077. https://www.cnki.com.cn/Article/CJFDTOTAL-HCYX202212026.htm
    [4]
    吴近仪, 吴敏杰, 魏鹏, 等. 早期综合康复治疗对改善中老年脑卒中偏瘫患者运动功能及日常生活能力的临床疗效观察[J]. 中华全科医学, 2022, 20(12): 2123-2126. doi: 10.16766/j.cnki.issn.1674-4152.002784

    WU J Y, WU M J, WEI P, et al. Clinical effect of early comprehensive rehabilitation therapy on improving the motor functions and activities of daily living in middle-aged and elderly stroke patients with hemiplegia[J]. Chinese Journal of General Practice, 2022, 20(12): 2123-2126. doi: 10.16766/j.cnki.issn.1674-4152.002784
    [5]
    中华医学会神经病学分会. 中国脑血管病诊治指南与共识2016版[M]. 北京: 人民卫生出版社, 2016.

    Neurology Branch of the Chinese Medical Association. Guidelines and consensus for the diagnosis and treatment of cerebrovascular diseases in China, 2016 edition[M]. Beijing: People ' s Health Publishing House, 2016.
    [6]
    张振诚, 王小艳. 取穴经皮神经电刺激联合康复训练治疗脑出血开颅术后痉挛性偏瘫的临床疗效[J]. 实用临床医药杂志, 2019, 23(18): 15-18. https://www.cnki.com.cn/Article/CJFDTOTAL-XYZL201918005.htm

    ZHANG Z C, WANG X Y. Effect of transcutaneous electrical nerve stimulation in selected acupoints combined with rehabilitation training in treatment of spastic hemiplegia after craniotomy[J]. Journal of Clinical Medicine in Practice, 2019, 23(18): 15-18. https://www.cnki.com.cn/Article/CJFDTOTAL-XYZL201918005.htm
    [7]
    姚安艳, 严璐. 脑卒中后运动功能障碍患者的康复训练研究进展[J]. 贵州中医药大学学报, 2022, 44(3): 91-95. https://www.cnki.com.cn/Article/CJFDTOTAL-GYZX202203018.htm

    YAO A Y, YAN L. Research progress on rehabilitation training for patients with post-stroke motor dysfunction[J]. Journal of Guizhaou University of Traditional Chinese Medicine, 2022, 44(3): 91-95. https://www.cnki.com.cn/Article/CJFDTOTAL-GYZX202203018.htm
    [8]
    张乃嘉, 高汉义. 针灸联合康复训练治疗脑卒中后肌痉挛的研究现状[J]. 中国医药科学, 2022, 12(13): 71-75. https://www.cnki.com.cn/Article/CJFDTOTAL-GYKX202213016.htm

    ZHANG N J, GAO H Y. Status quo of research on acupuncture and moxibustion combined with rehabilitation training in the treatment of spasticity of cerebral apoplexy[J]. China Medicine and Pharmacy, 2022, 12(13): 71-75. https://www.cnki.com.cn/Article/CJFDTOTAL-GYKX202213016.htm
    [9]
    孙彤, 贾子善, 戈含笑, 等. 脑卒中后肢体痉挛的物理治疗研究进展[J]. 中国康复理论与实践, 2019, 25(5): 497-505. https://www.cnki.com.cn/Article/CJFDTOTAL-ZKLS201905002.htm

    SUI T, JIA Z S, GE H X, et al. Advance in physical therapy for post-stroke limb spasticity (review)[J]. Chinese Journal of Rehabilitation Theory and Practice, 2019, 25(5): 497-505. https://www.cnki.com.cn/Article/CJFDTOTAL-ZKLS201905002.htm
    [10]
    GARCIA L C, ALCÂNTARA C C, SANTOS G L, et al. Cryotherapy reduces muscle spasticity but does not affect proprioception in ischemic stroke: a randomized sham-controlled crossover study[J]. Am J Phys Med Rehabil, 2019, 98(1): 51-57. doi: 10.1097/PHM.0000000000001024
    [11]
    崔友祥, 胡方梅, 王洪亮. A型肉毒毒素协同康复训练治疗脑卒中患者下肢肌痉挛的研究[J]. 双足与保健, 2019, 28(1): 47-48. https://www.cnki.com.cn/Article/CJFDTOTAL-SZBJ201901024.htm

    CUI Y X, HU F M, WANG H L. A study on the synergistic rehabilitation training of botulinum toxin type A in the treatment of lower limb muscle spasms in stroke patients[J]. Biped and Health, 2019, 28(1): 47-48. https://www.cnki.com.cn/Article/CJFDTOTAL-SZBJ201901024.htm
    [12]
    芦海涛, 崔利华, 王艺铮. 不同方式引导肉毒毒素注射治疗脑卒中后屈腕屈指肌痉挛的效果比较[J]. 中国康复理论与实践, 2019, 25(11): 1352-1355. https://www.cnki.com.cn/Article/CJFDTOTAL-ZKLS201911019.htm

    LU H T, CUI L H, WANG Y Z. Comparation of effects of botulinum toxin type a injection under different guidance approaches on wrist and finger spasticity in stroke patients[J]. Chinese Journal of Rehabilitation Theory and Practice, 2019, 25(11): 1352-1355. https://www.cnki.com.cn/Article/CJFDTOTAL-ZKLS201911019.htm
    [13]
    ATA E, GVLER M A, ADIGUZEL E. Ultrasonography-guided botulinum toxin injection for lumbrical muscle spasticity in a hemiplegic patient[J]. Med Ultrason, 2023, 25(2): 4105.
    [14]
    高永振. A型肉毒毒素对脑出血后下肢肌痉挛患者的影响及MAS评分影响观察[J]. 双足与保健, 2019, 28(13): 88-89. https://www.cnki.com.cn/Article/CJFDTOTAL-SZBJ201913052.htm

    GAO Y Z. Observation on the effect of type A botulinum toxin on lower limb muscle spasm patients after cerebral hemorrhage and the impact of MAS score[J]. Biped and Health, 2019, 28(13): 88-89. https://www.cnki.com.cn/Article/CJFDTOTAL-SZBJ201913052.htm
    [15]
    李纪仲, 马刚. A型肉毒毒素协同康复训练治疗脑卒中患者下肢肌痉挛[J]. 深圳中西医结合杂志, 2020, 30(20): 140-141. https://www.cnki.com.cn/Article/CJFDTOTAL-SZZX202020067.htm

    LI J Z, MA G. Type A botulinum toxin combined with rehabilitation training for the treatment of lower limb muscle spasms in stroke patients[J]. Shenzhen Journal of Integrated Traditional Chinese and Western Medicine, 2020, 30(20): 140-141. https://www.cnki.com.cn/Article/CJFDTOTAL-SZZX202020067.htm
    [16]
    陈昕, 关东升, 杨莉霞, 等. 神经肌肉电刺激联合康复护理延伸训练对脑卒中后肌痉挛患者的影响[J]. 齐鲁护理杂志, 2021, 27(7): 56-59. https://www.cnki.com.cn/Article/CJFDTOTAL-QLHL202107021.htm

    CHEN X, GUAN D S, YANG L X, et al. The effect of neuromuscular electrical stimulation combined with extended rehabilitation nursing training on patients with post-stroke muscle spasms[J]. Journal of Qilu Nursing, 2021, 27(7): 56-59. https://www.cnki.com.cn/Article/CJFDTOTAL-QLHL202107021.htm
    [17]
    刘华, 徐冬梅, 邓小渝, 等. 低频神经肌肉电刺激辅助治疗老年脑卒中后偏瘫肌痉挛对肌张力恢复的影响[J]. 中国老年学杂志, 2023, 43(5): 1114-1117. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLXZ202305027.htm

    LIU H, XU D M, DENG X Y, et al. The effect of neuromuscular electrical stimulation combined with extended rehabilitation nursing training on patients with post-stroke muscle spasms[J]. Chinese Journal of Gerontology, 2023, 43(5): 1114-1117. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLXZ202305027.htm
    [18]
    HALAKOO S, EHSANI F, MASOUDIAN N, et al. Does anodal trans-cranial direct current stimulation of the damaged primary motor cortex affects wrist flexor muscle spasticity and also activity of the wrist flexor and extensor muscles in patients with stroke? A randomized clinical trial[J]. Neurol Sci, 2021, 42(7): 2763-2773. doi: 10.1007/s10072-020-04858-9
    [19]
    黄华垚, 杜厚伟, 陈超, 等. 低频rTMS联合FES治疗对亚急性期缺血性脑卒中患者下肢痉挛及运动功能的康复作用[J]. 心血管康复医学杂志, 2019, 28(2): 134-138. https://www.cnki.com.cn/Article/CJFDTOTAL-XXGK201902002.htm

    HUANG H Y, DU H W, CHEN C, et al. Rehabilitative effect of low-frequency rTMS combined FES on lower limb spasm and motor function in patients with subacute ischemic stroke[J]. Chinese Journal of Cardiovascular Rehabilitation Medicine, 2019, 2802): 134-138. https://www.cnki.com.cn/Article/CJFDTOTAL-XXGK201902002.htm
    [20]
    刘雪洁, 王敏, 朱贵芹. MOTOmed智能训练联合痉挛肌电刺激对脑卒中病人下肢肌痉挛的临床疗效[J]. 蚌埠医学院学报, 2019, 44(3): 317-319, 324. https://www.cnki.com.cn/Article/CJFDTOTAL-BANG201903011.htm

    LIU X J, WANG M, ZHU G Q. Clinical effect of MOTOmed intelligent training combined with spastic myoelectric stimulation in the treatment of lower limb muscle spasticity in stroke patients[J]. Journal of Bengbu Medical College, 2019, 44(3): 317-319, 324. https://www.cnki.com.cn/Article/CJFDTOTAL-BANG201903011.htm
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Tables(5)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (51) PDF downloads(5) Cited by()
    Proportional views
    Related

    Address：No. 287, Changhuai Road, Bengbu, Anhui Province, 233004, P.R.ChinaphoneNo：0552-3066635； 0552-3051890Email：zhqkyx@163.com

    Copyright © Chinese Journal of General Practice皖ICP备2020018345号-2

    Supported by: Beijing Renhe Information Technology Co., Ltd.    

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return