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BACKGROUND: The abnormal gait of stroke patients seriously affects their propulsive force during walking, which subsequently reduces their walking speed, walking distance, and stability, increases their risk of falls, and seriously affects their quality of life. OBJECTIVE: To review the relevant research on propulsive force deficits in stroke patients with hemiplegia, to summarize the understanding of existing researchers on propulsive force deficits, to analyze the relationship between propulsive force and gait, and finally to explain and compare the latest rehabilitation technologies used to improve propulsive force deficits, providing reference for clinical treatment. METHODS: Relevant literature was retrieved from WanFang, CNKI, PubMed, and Web of Science Core Collection through computer search. The Chinese and English search terms were “propulsive force OR propulsive, stroke OR cerebral infarction OR hemiplegia, walk* OR gait.” The search time limit was from 2003 to 2023, and 71 articles were finally included for review and analysis. RESULTS AND CONCLUSION: Training targeting the hip and ankle joints may be more effective for patients’ walking function, especially training with the application of flexible exoskeleton robots, but more sufficient evidence is still needed to use propulsion as a prognostic indicator of walking function in stroke patients. Biomechanical variables related to propulsive force include: the hip joint extension angle at terminal stance, ankle joint dorsiflexion torque, and knee joint extension. Damage to the corticospinal tract, cerebellar-cortical pathways, and the reticulospinal tract in hemiplegic patients are associated with reduced propulsive force and gait asymmetry. Propulsive force is crucial for the stability of healthy gait, and a decrease in propulsive force is unfavorable for gait stability. Gait symmetry is correlated with propulsive force, stride length symmetry, trunk displacement, and lower limb swing ability, with propulsive force being a key factor. Propulsive force can serve as a quantitative indicator for assessing the gait of hemiplegic patients, and evaluation of gait using propulsive force is beneficial for the long-term development of walking ability. Main rehabilitation techniques for improving propulsive force include: lower limb exoskeleton robot walking training, treadmill training combined with functional electrical stimulation, adaptive speed treadmill training, biofeedback technology, and whole-body vibration training. Among them, whole-body vibration training and biofeedback technology are more effective. The specific contributions and mechanisms of the hip, knee, and ankle joints in improving propulsive force are still controversial, but it is expected that the contributions of the hip and ankle joints are greater. Focusing on the improvement of propulsive force as a rehabilitation goal may yield more sustainable advancements in walking function. However, several current challenges persist in this field: understanding the neurobiological basis of propulsive force deficits in stroke patients, assessing the long-term efficacy of current rehabilitation techniques for enhancing propulsive force, and determining the most suitable patient populations for the application of major rehabilitation techniques aiming at improving propulsive force. These areas require further exploration by subsequent researchers. [ABSTRACT FROM AUTHOR]

Objective To observe the effects of interactive scalp acupuncture on cognitive function, depression, anxiety and sleep quality in patients with post-stroke patients. Methods A total of 445 patients with stroke who had been admitted to the Rehabilitation Department of Nan'ao People's Hospital, Shenzhen Second People's Hospital and Shenzhen Futian District Hospital of Traditional Chinese Medicine from May 2019 to May 2020 were selected and randomly divided into the experimental group (n=223) and the control group (n=222), with 23 cases shed in the experimental group and 22 cases shed in the control group. Two groups of patients were treated with standard care and conventional rehabilitation exercise therapy. The experimental group was given interactive head acupuncture therapy, while the control group was given conventional scalp acupuncture and cognitive training therapy for a course of 8 weeks. Before the initial treatment, at the end of the treatment course, and at the follow-up 2 months later, Montreal Cognitive Assessment Scale (MoCA), Mini-mental State Examination (MMSE), Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), Pittsburgh Sleep Quality Index (PSQI), and Modified Barthel Index (MBI) were evaluated. The levels of serum Brain-derived Neurotrophic Factor (BDNF) and Nerve Growth factor (NGF)were measured before and after the first treatment. Results At the end of the treatment course and at the follow-up, the scores of MoCA, MMSE and MBI in the experimental group were increased compared with those before treatment (P＜ 0.01), and the scores of HAMD, HAMA and PSQI were decreased compared with those before treatment (P＜ 0.01). MoCA scores increased (P＜ 0.01) and HAMD scores of the control group decreased (P＜ 0.01) both at the end of the treatment course and at the follow-up, whereas MMSE and MBI scores of the control group increased only at the end of treatment (P< 0.01). The scores of MoCA, MMSE and MBI in the experimental group were higher than those in the control group at the end of the course and at the follow-up (P＜ 0.01), and the scores of HAMD, HAMA and PSQI in the experimental group were lower than those in the control group (P＜ 0.01). In terms of serological indexes, the levels of BDNF and NGF in both groups at the end of the course of treatment were higher than those before treatment (P＜ 0.01), and those in the experimental group were higher than those in the control group (P< 0.01). Conclusion Interactive scalp acupuncture can significantly improve not only the cognitive function, depression, anxiety but also the sleep quality and self-care ability of patients with stroke, and promote the recovery of cerebral nerve function. Compared with conventional rehabilitation treatment, it has the efficacy advantage which can be maintained after stopping the treatment. [ABSTRACT FROM AUTHOR]