Clinical study of electroacupuncture combined with rehabilitation training in the treatment of shoulder-hand syndrome after stroke

OBJECTIVE: To observe the effects of electroacupuncture combined with rehabilitation training on upper-limb motor function, pain and edema, range of motion of the shoulder and metacarpophalangeal joints, and activities of daily living in patients with post-stroke shoulder-hand syndrome, and to explore the therapeutic effect of electroacupuncture combined with rehabilitation training on post-stroke shoulder-hand syndrome. METHODS: 92 patients with post-stroke shoulder-hand syndrome were randomly divided into an electroacupuncture group (30 cases), a rehabilitation group (31 cases) and an electroacupuncture plus rehabilitation group (31 cases). All three groups were treated 6 times a week, with 4 weeks as one course. The electroacupuncture group received electroacupuncture once a day, the rehabilitation group received rehabilitation training once a day, and the combined group received both electroacupuncture and rehabilitation training once a day. Clinical functional assessments were performed before treatment and after one course: upper-limb motor function with the simplified upper-limb Fugl-Meyer assessment (FMA); upper-limb pain and edema with the visual analogue scale (VAS); shoulder range of motion with a goniometer; metacarpophalangeal range of motion scored by the distance between the thumb tip and the palm; and activities of daily living (ADL) with the modified Barthel index (MBI), followed by statistical analysis. After the course, the overall efficacy for shoulder-hand syndrome and the efficacy by stage were assessed and compared. RESULTS: The total effective rate was 93.55% in the electroacupuncture plus rehabilitation group, 83.33% in the electroacupuncture group and 67.74% in the rehabilitation group. In total effective rate, efficacy by stage, and improvement of upper-limb motor function, pain, swelling, and shoulder and metacarpophalangeal range of motion, the combined group was superior to the electroacupuncture group and the rehabilitation group, with very significant (P<0.01) and significant (P<0.05) differences. In improving shoulder pain and hand swelling, electroacupuncture was superior to rehabilitation (P<0.01). There was no significant difference among the three groups in the improvement of activities of daily living (P>0.05). CONCLUSION: Electroacupuncture combined with rehabilitation training has clear analgesic and anti-swelling effects on post-stroke shoulder-hand syndrome and improves joint range of motion; it can relieve spasticity, improve upper-limb motor function and increase shoulder and metacarpophalangeal range of motion, thus promoting functional recovery after stroke. Its efficacy in post-stroke shoulder-hand syndrome is superior to electroacupuncture alone or rehabilitation training alone.