Efficacy of acupuncture combined with upper limb rehabilitation robot-assisted training for neuroplasticity and functional recovery of patients with stroke: a prospective cohort study based on functional near-infrared spectroscopy technology

doi:10.19852/j.cnki.jtcm.2025.04.015

Abstract

Abstract:

OBJECTIVE: To investigate the effects of acupuncture combined with upper limb rehabilitation robot on neural remodeling and functional recovery in post-stroke patients.

METHODS: There were 50 stroke patients were randomly divided into an experimental group (acupuncture combined with upper limb rehabilitation robot assisted training) and a control group (upper limb rehabilitation robot assisted training). Various assessments were conducted to compare the effects of the two treatments on neural remodeling and functional recovery. Functional near-infrared spectroscopy technology was used to assess the effects of different treatments on neural plasticity and their impact on upper limb function and activities of daily living.

RESULTS: The experimental group showed significantly higher concentrations of oxygenated hemoglobin and total hemoglobin in specific brain regions compared to the control group (P < 0.05). Additionally, the experimental group had significantly lower concentrations of deoxygenated hemoglobin (P < 0.05). After treatment, both groups showed improvements in various measures, but the experimental group had significantly greater improvements (P < 0.05).

CONCLUSION: Acupuncture combined with upper limb rehabilitation robot can effectively improve upper limb function and neural remodeling in stroke patients. This study supports the integration of Traditional Chinese and Western Medicine in improving limb dysfunction post-stroke.

Key words: acupuncture, stroke, neuronal plasticity, upper limb rehabilitation robot, upper limb function

SONG Jianfei, QIN Zhengyuan, GU Xinlu, ZHANG Yan, LI Xingrui. Efficacy of acupuncture combined with upper limb rehabilitation robot-assisted training for neuroplasticity and functional recovery of patients with stroke: a prospective cohort study based on functional near-infrared spectroscopy technology[J]. Journal of Traditional Chinese Medicine, 2025, 45(4): 860-866.

Figures/Tables 2

References 25.

1.	Kimura H. Stroke. Brain Nerve 2020; 72: 311-21.
2.	Murala S, Nagarajan E, Bollu PC. Infectious causes of stroke. J Stroke Cerebrovasc Dis 2022; 31: 106274.
3.	Shah-Basak P, Boukrina O, Li XR, Jebahi F, Kielar A. Targeted neurorehabilitation strategies in post-stroke aphasia. Restor Neurol Neurosci 2023; 41: 129-91.
4.	Vitti E, Hillis AE. Treatment of post-stroke aphasia: a narrative review for stroke neurologists. Int J Stroke 2021; 16: 1002-8.
5.	Kim H, Wang K, Cutting LE, et al. The angular gyrus as a hub for modulation of language-related cortex by distinct prefrontal executive control regions. J Cogn Neurosci 2022; 34: 2275-96.
6.	Bijlsma A, Vanderschuren L, Wierenga CJ. Social play behavior shapes the development of prefrontal inhibition in a region-specific manner. Cereb Cortex 2023; 33: 9399-408.
7.	Chen Y, Zheng Y, Yan J, et al. Early life stress induces different behaviors in adolescence and adulthood may related with abnormal medial prefrontal cortex excitation/inhibition balance. Front Neurosci 2021; 15: 720286.
8.	Bao YC, Zhang F, Li Q, et al. Xingnao Kaiqiao acupuncture on promoting wake-up of vegetative state after brain injury. Zhong Guo Zhen Jiu 2021; 41: 1225-8.
9.	Cui J, Jia H. Xingnao kaiqiao acupuncture combined with butylphthalide sodium chloride injection in the treatment of acute cerebral infarction and its effect on the levels of serum malon-dialdehyde, superoxide dismutase, and glutathione peroxidase. Evid Based Complement Alternat Med 2022; 2022; 5990203.
10.	Song Z, Huang Q, Guo Y, et al. Xingnao kaiqiao acupuncture method combined with temporal three-needle in the treatment of acute ischemic stroke: a randomized controlled trial. Comput Intell Neurosci 2022; 2022: 8145374.
11.	Ren H, Liu T, Wang J. Design and analysis of an upper limb rehabilitation robot based on multimodal control. Sensors (Basel) 2023; 23: 8801.
12.	Chien WT, Chong YY, Tse MK, Chien CW, Cheng HY. Robot-assisted therapy for upper-limb rehabilitation in subacute stroke patients: a systematic review and Meta-analysis. Brain Behav 2020; 10: e01742.
13.	Rodgers H, Bosomworth H, Krebs HI, et al. Robot-assisted training compared with an enhanced upper limb therapy programme and with usual care for upper limb functional limitation after stroke: the RATULS three-group RCT. Health Technol Assess 2020; 24: 1-232. DOI PMID
14.	Zeng G, Song Y, Zhang Z, et al. Stress hyperglycemia ratio and long-term prognosis in patients with acute coronary syndrome: a multicenter, nationwide study. J Diabetes 2023; 15: 557-68. DOI PMID
15.	Zhang C, Shen HC, Liang WR, et al. Relationship between stress hyperglycemia ratio and allcause mortality in critically ill patients: results from the MIMIC-IV database. Front Endocrinol (Lausanne) 2023; 14: 1111026.
16.	Cao Y, Yu S, Zhang Q, et al. Chinese Stroke Association guidelines for clinical management of cerebrovascular disorders: executive summary and 2019 update of clinical management of intracerebral haemorrhage. Stroke Vasc Neurol 2020; 5: 396-402. DOI PMID
17.	Tu WJ, Wang LD. China stroke surveillance report 2021. Mil Med Res 2023; 10: 33.
18.	Saini V, Guada L, Yavagal DR. Global epidemiology of stroke and access to acute ischemic stroke interventions. Neurology 2021; 97 (20 Suppl 2): S6-16. DOI PMID
19.	Dehem S, Gilliaux M, Stoquart G, et al. Effectiveness of upper-limb robotic-assisted therapy in the early rehabilitation phase after stroke: a single-blind, randomised, controlled trial. Ann Phys Rehabil Med 2019; 62: 313-20. DOI PMID
20.	Takebayashi T, Takahashi K, Amano S, et al. Robot-assisted training as self-training for upper-limb hemiplegia in chronic stroke: a randomized controlled trial. Stroke 2022; 53: 2182-91.
21.	Heiberg AV, Simonsen SA, Schytz HW, Iversen HK. Cortical hemodynamic response during cognitive Stroop test in acute stroke patients assessed by fNIRS. Neuro Rehabilitation 2023; 52: 199-217.
22.	Wang WY, Wan FM, Ding SQ. Clinical observation of Jingu three-needle therapy combined with Xingnao Kaiqiao acupuncture on complex regional pain syndrome after stroke. Zhong Guo Zhen Jiu 2019; 39: 1262-6.
23.	Li MH, Lu H, Du YH, Lu LX, Meng ZH. Acupotomy combined with Xingnao Kaiqiao acupuncture therapy in treatment of sensory impairment in the recovery stage of cerebral infarction: a randomized controlled trial. Zhong Guo Zhen Jiu 2021; 41: 9-12.
24.	Yu L, Fan XN. Idea of shen-brain-orifice in the acupuncture system of Xingnao Kaiqiao. Zhong Guo Zhen Jiu 2019; 39: 883-6.
25.	Wu MX, Sheng RY, Sun DW, Lu H, Zhang CH. Panlong acupuncture combined with Xingnao Kaiqiao acupuncture for post-stroke fatigue: a randomized controlled trial. Zhong Guo Zhen Jiu 2022; 42: 1089-93.

Item	Control group	Experimental group	t/χ²value	P value
Age (years)	58.5±6.3	57.9±7.1	0.286	0.776
Gender (male/female) [n (%)]	15 (60.00)/10 (40.00)	13 (52.00) / 12 (48.00)	0.081	0.776
BMI (kg/cm²)	24.4±2.1	24.9±1.9	0.833	0.409
Smoking history [n (%)]	6 (24.00)	8 (32.00)	0.099	0.753
Drinking history [n (%)]	6 (24.00)	9 (36.00)	0.381	0.537
Hypertension [n (%)]	6 (24.00)	4 (16.00)	0.125	0.724
Diabetes [n (%)]	5 (20.00)	3 (12.00)	0.149	0.700
Hyperlipidemia [n (%)]	5 (20.00)	3 (12.00)	0.149	0.700
Coronary heart disease [n (%)]	2 (8.00)	4 (16.00)	0.189	0.663
Post-stroke duration (months)	5.6±2.1	5.8±2.0	0.257	0.798
Lesion location (left/right) [n (%)]	14 (56.00) /11 (44.00)	12 (48.00)/13 (52.00)	0.080	0.777
NIHSS initial score	7.2±2.3	7.6±2.0	0.548	0.586
Overweight or obesity [n (%)]	3 (12.00)	1 (4.00)	0.272	0.602
Stroke type [n (%)]			0.083	0.773
Ischemic stroke	14 (56.00)	16 (64.00)
Hemorrhagic stroke	11 (44.00)	9 (36.00)

Item	Control group	Experimental group	t/χ²value	P value
Age (years)	58.5±6.3	57.9±7.1	0.286	0.776
Gender (male/female) [n (%)]	15 (60.00)/10 (40.00)	13 (52.00) / 12 (48.00)	0.081	0.776
BMI (kg/cm²)	24.4±2.1	24.9±1.9	0.833	0.409
Smoking history [n (%)]	6 (24.00)	8 (32.00)	0.099	0.753
Drinking history [n (%)]	6 (24.00)	9 (36.00)	0.381	0.537
Hypertension [n (%)]	6 (24.00)	4 (16.00)	0.125	0.724
Diabetes [n (%)]	5 (20.00)	3 (12.00)	0.149	0.700
Hyperlipidemia [n (%)]	5 (20.00)	3 (12.00)	0.149	0.700
Coronary heart disease [n (%)]	2 (8.00)	4 (16.00)	0.189	0.663
Post-stroke duration (months)	5.6±2.1	5.8±2.0	0.257	0.798
Lesion location (left/right) [n (%)]	14 (56.00) /11 (44.00)	12 (48.00)/13 (52.00)	0.080	0.777
NIHSS initial score	7.2±2.3	7.6±2.0	0.548	0.586
Overweight or obesity [n (%)]	3 (12.00)	1 (4.00)	0.272	0.602
Stroke type [n (%)]			0.083	0.773
Ischemic stroke	14 (56.00)	16 (64.00)
Hemorrhagic stroke	11 (44.00)	9 (36.00)

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