| Objective: With the progress of medical treatment,the death rate of stroke is decreasing year by year in China,but the disability rate of stroke is still high.Upper limb dysfunction after stroke is the main factor causing persistent disability of stroke survivors,which seriously affects the daily life of patients and hinders their return to family and society.In this study,cross-education,EMG biofeedback and crosseducation combined with EMG biofeedback were used to intervene the upper limbs of stroke patients in subacute stage.The improvement of upper limb motor function and activities of daily living of stroke patients before and after the intervention were evaluated by relevant scales,so as to provide more effective treatment methods for the rehabilitation of upper limb function of stroke,At the same time,it also provides a theoretical basis for clinical treatment.Methods: Thirty patients with subacute stroke who were hospitalized in the Department of rehabilitation medicine of Taixing people’s Hospital of Jiangsu Province from December 2020 to September 2021 and met the inclusion criteria were randomly divided into three groups: cross-education group,EMG biofeedback group and combined group.On the basis of routine rehabilitation training,the crosseducation group received cross-education intervention（1hour/time）,the EMG biofeedback group received EMG biofeedback intervention（1hour/time）,and the combined group received cross-education combined with EMG biofeedback intervention（2hours/time）.Each group was intervened for 6 weeks,and the following evaluations were performed before,3 weeks after and 6 weeks after the intervention:upper limb motor function assessment（FMA-UE）,Brunnstrom stage,activity of daily living assessment（MBI）,upper limb unarmed muscle strength assessment（deltoid middle bundle,triceps brachii,extensor carpi dorsi）,and upper limb active range of motion（AROM）assessment（shoulder abduction,wrist dorsiflexion）.The above evaluation results were statistically analyzed.One way ANOVA was used between groups and repeated measurement ANOVA was used within groups.P < 0.05 was a significant difference,indicating statistical significance.Results:（1）FMA-UE score: Compared with before the intervention,after 3 weeks and 6weeks after the intervention,the FMA-UE scores of the three groups increased and there was a significant difference（P<0.05）;compared with the 3 weeks after the intervention,the 6 weeks of the intervention The FMA-UE scores of the last three groups all improved and there was a significant difference（P<0.05）.After 3 weeks of intervention,there was no significant difference in FMA-UE scores between the three groups（P>0.05）;after 6 weeks of intervention,there was no significant difference in FMA-UE scores between the three groups,except for the comparison between the cross-education group and the EMG feedback group（P>0.05）,there were significant differences between the combined group and the EMG feedback group,and the combined group and the cross-education group（P<0.05）,and the score of the combined group was higher than that of the cross-education group and the EMG feedback group.（2）Brunnstrom stage: Compared with before the intervention,after 3 weeks of intervention and 6 weeks of intervention,the Brunnstrom（upper limb）/Brunnstrom（hand）scores of the three groups increased and there was a significant difference（P<0.05）;it was similar to that after 3 weeks of intervention.In comparison,the Brunnstrom（upper limb）score/Brunnstrom（hand）score of the three groups increased after 6 weeks of intervention and there was a significant difference（P<0.05）.There was no significant difference in Brunnstrom（upper limb）scores between the three groups after 3 weeks of intervention（P>0.05）.After 6 weeks of intervention,Brunnstrom（upper limb）scores were compared between the three groups.Except for the cross-education group and the EMG feedback group,there was no significant difference（P>0.05）.The combined group was compared with the EMG feedback group,and the combined group and the cross-education group.There were significant differences（P<0.05）,and the scores of the combined group were higher than those of the cross-education group and the EMG feedback group.There was no significant difference in Brunnstrom（hand）scores between the three groups after 3weeks of intervention and 6 weeks after intervention（P>0.05）.（3）Muscle strength: Compared with before the intervention,after 3 weeks of intervention,the three groups of deltoid（middle bundle）muscle strength scores were not significantly different（P>0.05）;after 6 weeks of intervention,the three groups of deltoid（middle bundle）muscle strength scores Both increased and there was a significant difference（P<0.05）.Compared with the intervention after 3 weeks,the deltoid muscle（middle bundle）muscle strength score of the combined group increased and there was a significant difference（P<0.05）after 6 weeks of intervention.The deltoid muscle（middle bundle）muscle of the cross migration group and the EMG feedback group There was no significant difference in the force scores（P>0.05）.Compared with before the intervention,after 3 weeks of intervention and 6weeks of intervention,the muscle strength scores of the three groups of triceps/carpal dorsi extensor muscles all improved and there were significant differences（P<0.05）.Compared with the intervention after 3 weeks,the triceps muscle strength scores of the three groups increased after 6 weeks of intervention and there were significant differences（P<0.05）;after 6 weeks of intervention,the combined group and cross migration group extensor wrist muscle strength The scores were improved and there was a significant difference（P<0.05）.There was no significant difference in the muscle strength scores of the dorsi wrist extensor in the EMG feedback group（P>0.05）.After 3 weeks of intervention,there was no significant difference in the deltoid（middle bundle）muscle strength score/triceps muscle strength score/carpal back extensor muscle strength score comparison among the three groups（P>0.05）.After 6weeks of intervention,the deltoid（middle bundle）muscle strength score/triceps muscle strength score/carpal dorsi extensor muscle strength score were compared,except for the comparison between the cross migration group and the EMG feedback group,there was no significant difference（P>0.05）In addition,there were significant differences between the combined group and the EMG feedback group,the combined group and the cross-education group（P<0.05）,and the score of the combined group was higher than that of the cross migration group and the EMG feedback group.（4）AROM:Compared with before the intervention,after 3 weeks of intervention and 6 weeks of intervention,the AROM of shoulder joint abduction/wrist extension AROM of the three groups increased and there was a significant difference（P<0.05）;compared with after 3 weeks of intervention,After 6 weeks of intervention,the AROM of shoulder joint abduction/wrist joint dorsiflexion of the three groups increased and there was a significant difference（P<0.05）.After 3 weeks of intervention,there was no significant difference in shoulder abduction AROM between the three groups（P>0.05）.The comparison of shoulder abduction AROM/wrist dorsiflexion AROM between the three groups after 6 weeks of intervention,except for the cross-education group and the EMG feedback group,there is no significant difference（P>0.05）,the combined group and the crosseducation group,the combined group and There were significant differences between the EMG feedback group（P<0.05）,and the AROM of the combination group was higher than that of the cross-education group and EMG feedback group.Comparison of wrist dorsal extension AROM between the three groups after 3 weeks of intervention,except for the significant difference between the combined group and the EMG feedback group（P<0.05）and the combined group’s AROM was higher than the EMG feedback group,the combined group and the cross-education group There was no significant difference between the cross-education group and the EMG feedback group（P>0.05）.（5）ADL score:Compared with before the intervention,after 3 weeks and 6 weeks after the intervention,the ADL scores of the three groups increased and there was a significant difference（P<0.05）;compared with the 3 weeks after the intervention,the ADL scores of the three groups all increased after the intervention for 6 weeks And there is a significant difference（P<0.05）.There was no significant difference in ADL scores between the three groups after3 weeks of intervention and 6 weeks after intervention（P>0.05）.Conclusions:（1）Cross-education,EMG biofeedback,and cross-education combined with EMG biofeedback all improved upper limb motor function and daily living activities in subacute stroke patients,and the intervention effect of 6 weeks was better than 3weeks;（2）Cross-education,EMG biofeedback,and cross-education combined with EMG biofeedback have similar effects on improving the ability of daily living activities and Brunnstrom（hand）stage in subacute stroke patients.In terms of improving upper limb motor function and Brunnstrom（upper limb）stage,Cross-education combined with EMG biofeedback is superior to cross-education or EMG biofeedback alone. |
PDF Full Text Request