| Objective: To observe the clinical efficacy of acupuncture combined with transcranial direct current stimulation of the foot movement sensor for post-stroke urinary incontinence based on the theory of pair-associative stimulation. Methods: A total of 81 patients who met the inclusion criteria were randomly divided into acupuncture group, transcranial direct current group and combined stimulation group. The three groups received basic treatment. In the acupuncture group, Guanyuan, Zhongji, Shenshu and Bladdershu were selected; the transcranial direct current group was given transcranial direct current to stimulate the foot movement sensing area; In the combined stimulation group, the patients received acupuncture at Guanyuan, Zhongji, Shenshu, and Yiyanshu at the same time during transcranial direct current stimulation of the foot movement sense area. Before the initial treatment and at four weeks after the treatment, all three groups of patients were analyzed by the same person on the International Urinary Incontinence Advisory Committee Urinary Incontinence Questionnaire (ICI-Q-SF), Urinary Incontinence Quality of Life Questionnaire (I-QOL) and pelvic floor electromyography to evaluate bladder function and electrophysiological changes of pelvic floor muscles. Results: After treatment, the contractions of pelvic floor myoelectric fast muscle, comprehensive muscle, and slow muscle increased as compared with those before treatment (P<0.05), and the scores of ICI-Q-SF and I-QOL were all improved (P<0.05). After treatment, there was no significant difference in the amplitude of fast-twitch muscle fiber contraction among the three groups (P>0.05). The changes of comprehensive muscle fiber contraction amplitude in the combined stimulation group was significantly higher than in the acupuncture group and the transcranial direct current group (P<0.05), but there was no signific-ant difference between the acupuncture group and the transcranial direct current group (P>0.05). The changes of slow muscle fiber contraction amplitude in the combined stimulation group were significantly greater than in the acupuncture group and the transcranial direct current group (P<0.05), but there was no sig-nificant difference between the acupuncture group and the transcranial direct current group (P>0.05). After treatment, the changes in ICI-Q-SF and I-QOL scale scores in the combined stimulation group were significantly greater than those in the acupuncture group and transcranial direct current group (P<0.05), but there was no significant difference between the acupuncture group and transcranial direct current group (P>0.05). Conclusion: Acupuncture combined with transcranial direct current stimulation of the foot movement area can improve the endurance and coordination of the pelvic floor muscles to a greater extent. |
