Transcutaneous electrical nerve stimulation on acupuncture points decreases spasticity and improves muscle strength of the affected lower extremity in subjects with acute stroke.

OBJECTIVE: To observe the effect of transcutaneous electrical nerve stimulation (TENS) on lower limb muscle spasm in patients with acute stroke. METHODS: 50 stroke patients who met the inclusion criteria and did not withdraw due to other circumstances (recurrent stroke, voluntary withdrawal, language barrier, etc.) Cases, with an average age of (70.0±7.4) years and an average disease duration of (9.2±3.4) days, were randomly divided into TENS group (17 cases) and sham stimulation group (17 cases) through computer stratification (stroke nature, gender, age) and the control group (16 cases). The subjects in the three groups all received conventional drugs and rehabilitation training. The TENS group used 2 TENS treatment devices (each with 2 output channels), and surface electrodes were placed on 8 acupoints on the paralyzed limb ( 4 upper and lower limbs each) were given electrical stimulation; the sham stimulation group used the same model of treatment instrument, treatment parameters and treatment sites, but no current output. The above treatment was once a day, 60 minutes each time, 5 times a week. A total of 15 treatments were performed. The Comprehensive Spasticity Scale (CSS) was used to evaluate the spasticity of the patient's ankle plantar flexor muscles before treatment, every week during treatment, and during follow-up 8 weeks after the onset of disease. Surface electromyography was used to evaluate the ankle dorsiflexion and ankle plantar flexor muscles. Strength and analyze the performance of integrated electromyography and the co-contraction rate of spastic muscles and antagonist muscles. RESULTS: Before treatment, there were no statistically significant differences in muscle tension, surface electromyography performance and performance ability between the three groups. Treatment Analysis of variance after neutralization treatment found that the differences between the three groups were statistically significant. Among them, the normal muscle tone of the ankle plantar flexor muscles in the TENS group increased significantly after 1 week of treatment compared with the control group, and surface electromyography showed that after 2 weeks of treatment The muscle strength of the ankle dorsiflexor muscles in the posterior TENS group was increased compared with the control group, and the synergistic contraction rate of the antagonist muscle groups during ankle dorsiflexion was significantly reduced after 3 weeks of treatment (P<0.05). The above differences continued until the follow-up evaluation 8 weeks after the onset of disease. (P<0.05). CONCLUSION: Compared with the sham stimulation group and the control group, TENS treatment on the acupoints of the paralyzed limb for 3 weeks can significantly reduce the occurrence of ankle plantar flexor muscle spasm in acute stroke patients within 2 weeks of onset. It also delays its development and enhances the contraction function of the ankle dorsal extensor muscles.