Effects of Acupuncture Combined with External Diaphragm Pacing on Diaphragmatic Function in Patients with Severe Stroke after Tracheostomy
Year: 2026
Type: article
Study designs: Randomized Controlled Trial, Clinical Trial
Abstract: ObjectiveTo evaluate the effects of acupuncture combined with external diaphragm pacing on diaphragmatic function in patients with severe stroke after tracheostomy.MethodsA total of 60 patients with severe stroke after tracheostomy admitted to the Department of Critical Rehabilitation of Shanghai Third Rehabilitation Hospital from July 2021 to July 2023 were enrolled and randomly divided into control group and experimental group, with 30 cases in each group. Both groups received conventional clinical treatments (oxygen inhalation, nebulization, and anti-infection) and respiratory rehabilitation training (pursed-lip breathing, diaphragmatic breathing, and sandbag resistance training for abdominal muscles). The control group received external diaphragm pacing in addition to the conventional treatment and respiratory training. External diaphragm pacing was set at 12-18 times a minute, stimulation intensity of 10-15 mA, pulse frequency of 40 Hz, 30 minutes per session, once daily, five times per week, for a total of six weeks. The experimental group received acupuncture in addition to the control group’s regimen. The selected acupuncture points included bilateral Geshu, bilateral Feishu, Danzhong, bilateral Lieque, and bilateral Neiguan. Needles were retained for 30 minutes per session, once daily, five times per week, for a total of six weeks. Before and after treatment, color Doppler imaging was used to assess diaphragmatic thickness, diaphragmatic thickness fraction, and diaphragmatic excursion during quiet breathing. The Modified Borg Dyspnea Scale (mBorg) was used to assess respiratory function. The Modified Barthel Index (MBI) was used to evaluate activities of daily living. Arterial blood gas analysis was performed to determine partial pressure of oxygen (PaO₂) and partial pressure of carbon dioxide (PaCO₂). Serum levels of C-reactive protein, procalcitonin, and interleukin-6 (IL-6) were measured by dry immunofluorescence. Within one week after treatment, the success rates of tracheostomy capping trial and decannulation were assessed. Adverse reactions during treatment were observed.Results(1) Diaphragmatic thickness, diaphragmatic thickness fraction, and diaphragmatic excursion: compared with those before treatment, diaphragmatic thickness, diaphragmatic thickness fraction, and diaphragmatic excursion in both groups significantly increased after treatment (P<0.05). Compared with the control group, diaphragmatic thickness fraction and diaphragmatic excursion in the experimental group were significantly higher after treatment (P<0.05), while no statistically significant difference was observed in diaphragmatic thickness (P>0.05). (2) Respiratory function and MBI scores: compared with those before treatment, mBorg scores in both groups significantly decreased after treatment (P<0.05), while MBI scores in both groups significantly increased after treatment (P<0.05). Compared with the control group, mBorg score in the experimental group was significantly lower after treatment (P<0.05), and MBI score in the experimental group was significantly higher after treatment (P<0.05). (3) PaO₂ and PaCO₂: compared with those before treatment, PaO₂ of both groups significantly increased after treatment (P<0.05), while PaCO₂ significantly decreased after treatment (P<0.05). Compared with the control group, PaO₂ in the experimental group was significantly higher after treatment (P<0.05), and PaCO₂ was significantly lower after treatment (P<0.05). (4) Inflammatory markers: compared with those before treatment, C-reactive protein, procalcitonin, and IL-6 levels in both groups significantly decreased after treatment (P<0.05). Compared with the control group, C-reactive protein, procalcitonin and IL-6 levels in the experimental group were significantly lower after treatment (P<0.05). (5) Success rates of tracheostomy capping trial and decannulation: there was no statistically significant difference between two groups in the success rates of tracheostomy capping trial and decannulation (P>0.05). (6) Safety: no adverse reactions occurred during external diaphragm pacing treatment in either group. Two cases of minor bleeding at the acupuncture sites in the experimental group were observed during treatment, with no other adverse reactions such as pain at acupuncture points, needle fainting, or skin allergy at the puncture sites.ConclusionAcupuncture combined with external diaphragm pacing can enhance diaphragmatic function, improve respiratory function, reduce levels of inflammatory factors, and increase activities of daily living in severe stroke patients with tracheostomy.
Source: Rehabilitation Medicine
Authors: Saisai CHEN, Hao HUANG, Ru YA, Jingyi HAO, Deng LIU
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7160645231
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