| Objective:The combination of electro-acupuncture and mirror therapy was used to observe and analyze its effects on the degree of nerve defect,ankle mobility,lower limb motor function and balance function of patients with ankle dysfunction after stroke,and further observe the effects of different therapies on lower limb s EMG from the electro-physiological point of view,so as to optimize the treatment scheme of ankle dysfunction after stroke.Methods:90 patients with post-stroke ankle dysfunction who met the inclusion criteria were randomly divided into electro-acupuncture group,mirror group and electro-acupuncture combined with mirror group(hereinafter referred to as combined group)with 30 cases in each group.All patients received routine basic treatment.On this basis,the electro-acupuncture group: select Biguan,Liangqiu,Xuehai,Yanglingquan,Zusanli,Fenglong,Xuanzhong,Jiexi,Qiuxu,Zhaohai and Taichong;One-time sterile acupuncture with the specification ofΦ0.30×40mm was selected to acupuncture points to relieve diarrhea.Connect a continuous wave,2HZ frequency KWD-808 I pulse acupuncture therapeutic instrument(Indy brand)to treat patients.Leave the needle for 30 minutes.Mirror group: a quiet and single background treatment environment was selected.The patient sat in a chair or hospital bed with his feet drooping naturally,and a mirror was placed vertically between his lower limbs,with the same posture on both feet.The affected foot is placed behind the mirror,and the healthy side is placed in front of the mirror;The therapist shows the movements that the patient needs to perform.The patient’s healthy foot completes ankle dorsiflexion,ankle plantarflexion,varus,valgus and toe dorsiflexion according to the instructions,and each movement is 5 times,with a rest of 10 seconds after one movement.Five movements of ankle dorsiflexion,ankle plantarflexion,varus,valgus and toe dorsiflexion are counted as one group,and after one group,they rest for 1 minute,making a total of 5 groups.At the same time,observe the mirror image of the healthy foot in the mirror with both eyes,guide the patient to imagine that the affected foot is participating in the activities of the healthy foot at the moment,and let the patient try to exercise both sides at the same time as possible.Mirror therapy lasts about 30 minutes.Combined group: mirror image therapy was used after electro-acupuncture treatment.The electro-acupuncture group,mirror image group and combined group were all treated once a day,6 days a week and 1 day off for 4 weeks.The effective rate of patients was evaluated by using the Neurological Deficit Assessment Scale(CSS),ankle dorsiflexion angle measurement,lower limb motor function evaluation by Fugl-Meyer Scale(FMA)and balance ability evaluation by Berg Balance Scale(BBS).The s EMG of patients with tibialis anterior was collected and the root mean square value(RMS)was extracted to analyze the tibialis anterior muscle strength of patients,which were measured before the first treatment and after the last treatment.The analysis of statistics is processed by SPSS24.0 software.Results:1.Of the 90 patients included in the experiment,4 cases fell off,including 1 in the combined group,1 in the electro-acupuncture group and 2in the mirror group.A total of 86 patients completed the experiment,including 29 patients in electro-acupuncture group,28 patients in mirror image group and 29 patients in combination group.The general conditions(age,sex,course of disease and hemiplegia side)of the three groups of patients,as well as the CSS score,ankle dorsiflexion angle,FMA score,BBS score and s EMG RMS value of the three groups of patients before treatment,have no statistical difference(P>0.05),which is comparable.2.Clinical efficacy: after 4 weeks of treatment,the total effective rate of electro-acupuncture group was 79.31%;The total effective rate of mirror group was 75.00%;The total effective rate of the combined group was 86.21%.It is suggested that electro-acupuncture,mirror image therapy and electro-acupuncture combined with mirror image therapy have good curative effects.3.CSS score: CSS scores of electro-acupuncture group,mirror group and combined group decreased after treatment(P<0.01),and the combined group was better than electro-acupuncture group and mirror group(P<0.05).4.Angle of ankle dorsiflexion joint: After treatment,the angle of ankle dorsiflexion joint in electro-acupuncture group,mirror image group and combined group increased(P<0.01),and the combined group was better than electro-acupuncture group and mirror image group(P<0.05).5.FMA score: After treatment,the scores of FMA in electro-acupuncture group,mirror group and combined group all increased(P<0.01),and the combined group was better than electro-acupuncture group and mirror group(P<0.05).6.BBS score: The BBS score of electro-acupuncture group,mirror group and combined group increased after treatment(P<0.01),and the combined group was better than electro-acupuncture group and mirror group(P<0.05).7.Tibialis anterior RMS value: Tibialis anterior RMS value of electro-acupuncture group,mirror group and combined group increased after treatment(P<0.01),and combined group was better than electro-acupuncture group and mirror group(P<0.05).Conclusion:1.Electro-acupuncture,mirror image therapy and electro-acupuncture combined with mirror image therapy can improve the degree of nerve defect,ankle joint activity,lower limb movement function,limb balance function and tibialis anterior muscle strength of patients,and improve their daily living ability.2.Electro-acupuncture combined with mirror image therapy can better improve the degree of nerve defect,ankle joint activity,lower limb movement function,limb balance function,tibialis anterior muscle strength and improve the daily living ability of patients compared with electro-acupuncture or mirror image therapy alone.3.Electro-acupuncture combined with mirror image therapy to promote ankle function reconstruction in stroke patients may be related to the improvement of tibialis anterior muscle strength. |
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