A Retrospective Study On The Effects Of Different Rehabilitation Methods On Ankle Dorsiflexion In Hemiplegic Patients With Stroke

Objective:The rehabilitation effects of various rehabilitation methods were analyzed retrospectively in patients with a history of stroke and hemiplegia.For this purpose,assistance was provided in choosing the best treatment for clinical rehabilitation.Methods:A retrospective study method was used to collect and compare clinical data on 424 patients with posttraumatic ankle dysfunction after stroke who met admission criteria in this study and were admitted to the rehabilitation department of the first hospital of Jilin university from September 1,2019 to November 30,2022.The 194 patients who received 40min/day CR and 20min/day LFES were labeled as the routine group,and the 40 patients who received 15min/day EMG-BFT on top of the routine group were labeled as the biofeedback group.The 123 patients who received 15min/day rPMS in addition to the conventional group were labeled as the peripheral magnetic stimulation group,and the 67 patients who received 15min/day EMG-BFT and 15min/day rPMS in addition to the conventional group were labeled as the combined treatment group.The above treatments were given once/day,6 days/week for a total of 3 weeks.Collect and analyze the Manual Muscle Testing(MMT),Modified Ashworth Scale(MAS),Active range of motio(AROM),Brunnstrom Stage-lower limb,lower limb Fugl-Meyer Motor Function Rating Scale(FMA-LE),Functional Ambulation Classification(FAC)and Barthel Index(BI)were compared to observe the recovery of ankle dorsiflexion dysfunction in the four groups of patients,and the data of the four groups were statistically analyzed.Results:(1)There were no significant differences in MMT of ankle dorsiflexion,MAS of ankle plantarflexor,AROM of ankle dorsiflexion,Brunnstrom stage-lower extremity,FMA-LE and scores of ankle dorsiflexion,FAC and BI among the four groups(P>0.05),which were comparable.(2)Intra-group comparison:After treatment,the MMT of ankle dorsiflexion muscle,MAS of ankle plantar flexor muscle,AROM of ankle dorsiflexion,Brunnstrom stage of lower limbs,FMA-LE and scores of ankle dorsiflexion part,FAC and BI scores of the four groups were better than those before treatment(P<0.05).(3)After treatment,the MMT of ankle dorsiflexion muscle,MAS of ankle plantar flexor muscle,Brunnstrom staging of lower limbs,FAC,FMA-LE,and BI in the biofeedback group were better than in the conventional group(P<0.05).In AROM between the biofeedback group and the conventional group,there was no significant difference(P>0.05).The MAS of ankle plantar flexor,AROM of ankle dorsiflexion,FMA-LE,FAC,and BI scores of patients in the peripheral magnetic stimulation group were better than those in the conventional group(P<0.05).There were no significant differences in MMT of ankle dorsiflexion muscle and Brunnstrom staging of lower limbs between the peripheral magnetic stimulation group and the conventional group(P>0.05).The MMT of ankle dorsiflexion muscle,MAS of ankle plantar flexor muscle,AROM of ankle dorsiflexion,Brunnstrom staging of lower limbs,FMA-LE,FAC,BI of the combined treatment group were better than those the conventional group,especially the improvement of supine flexor cooperative movement and ankle dorsiflexion was more significant(P<0.05).The scores of ankle dorsiflexion MMT,ankle plantar flexor MAS,ankle dorsiflexion AROM,Brunnstrom stage-lower extremity,FMA-LE,FAC,and BI in the peripheral magnetic stimulation group were better than those in the biofeedback group(P<0.05).The MMT of ankle dorsiflexion muscle,MAS of ankle plantar flexor muscle,AROM of ankle dorsiflexion,Brunnstrom staging of lower limbs,FMA-LE,FAC,and BI scores of patients in the combined treatment group were better than those in the biofeedback group(P<0.05).The MMT of ankle dorsiflexion muscle,Brunnstrom staging of lower limbs,FAC and BI scores in the combined treatment group were better than those in the peripheral magnetic stimulation group(P<0.05).There were no significant differences in MAS of ankle plantar flexors,AROM of ankle dorsiflexion,and FMA-LE scores between the combined treatment group and the peripheral magnetic stimulation group(P>0.05).Conclusions:(1)All the rehabilitation methods involved in this study can improve the muscle strength of ankle dorsiflexion muscle and AROM of ankle dorsiflexion muscle,reduce the muscle tone of ankle plantar flexor muscle,and improve the ankle dorsiflexion function,lower limb motor function,walking function and ADL ability of patients after stroke.(2)rPMS,EMG-BFT and rPMS combined therapy have better effects in improving ankle plantar flexor muscle tension,ankle dorsiflexion AROM and lower limb motor function,especially in the supine flexor synkinetic-ankle dorsiflexion.(3)EMG-BFT combined with rPMS was more effective in improving ankle dorsiflexion muscle strength,walking function and ADL.(4)The combination of EMG-BFT and rPMS can effectively improve the ankle dorsiflexion dysfunction of patients after stroke,which can provide a reference for the formulation of the best clinical rehabilitation treatment plan.