Effects Of Electromyographic Biofeedback Therapy Combined With Mirror Therapy On Lower Limb Function Reconstruction In Stroke Patients

Objective: To study the influence of electromyographic biofeedback therapy(EMGBFT)combined with mirror therapy(MT)on lower limb motor and balance function,walking and activities of daily living in stroke patients,and to analyze the relationship between lower limb motor function score and exercise compliance.Methods: Sixty stroke patients were randomly divided into sham MT group and real MT group,with 30 people in each group.Based on conventional treatment,the patients in the sham MT group received sham MT stimulation combined with EMGBFT,and the patients in the real MT group received MT combined with EMGBFT.Before and after 4 weeks of treatment,the lower limb motor function of the patients was evaluated using the Fugl-Meyer assessment scale-lower extremity(FMA-LE),Brunnstrom stage(BS),passive range of motion(PROM),modified Ashworth scale(MAS)and surface electromyography;Berg balance scale(BBS)and plantar pressure parameters were used to evaluate the balance function;functional ambulation category(FAC)was used to evaluate the walking function;modified Barthel index(MBI)was used to evaluate the activities of daily living;questionnaire of exercise adherence(EAQ)was used to evaluate the compliance of stroke patients with medical orders.Results: There was no statistically significant difference in the general information of the two groups of patients before treatment(P > 0.05).After treatment,the scores of FMA-LE,BS,PROM,MAS of rectus femoris and medial gastrocnemius,BBS,FAC,MBI,EAQ and all dimensions in the two groups were markedly ameliorated,and the FMA-LE increment score was positively correlated with EAQ increment score,and the differences were statistically significant(P < 0.05,P < 0.01);the integrated electromyography(i EMG)and co-contraction ratio(CR)of biceps femoris and rectus femoris,tibialis anterior and medial gastrocnemius in the two groups were markedly ameliorated,and the differences were statistically significant(P < 0.01);during eye-opening,the symmetry index(SI)of mean pressure and contact area of both feet,body center of gravity elliptical area,anteroposterior(AP)and mediolateral(ML)displacement distance were greatly enhanced in the two groups,during eye-closing,the SI of mean pressure and contact area of both feet,ML displacement distance of body center of gravity were observably ameliorated in the two groups,and the differences were statistically significant(P < 0.05,P < 0.01).Compared with the sham MT group after treatment,the FMA-LE,BS,PROM,BBS,FAC,MBI,EAQ and all dimensions,the i EMG of biceps femoris and tibialis anterior,body center of gravity elliptical area and body center of gravity AP and ML displacement distance with eyes open,and the SI of contact area of both feet with eyes closed changed more significantly in the real MT group,and the differences were statistically significant(P < 0.05,P < 0.01).Conclusion:(1)Compared with electromyographic biofeedback therapy,electromyographic biofeedback therapy combined with mirror therapy is more effective in improving the motor and balance function of lower limbs,and promoting the recovery of walking and activities of daily living in stroke patients.It more obviously activates the motor unit of lower limb weak muscle group and improves the static balance ability of standing position.(2)Under the intervention of two different treatment programs,there is a positive correlation between the compliance of functional exercise and the motor function of lower limbs in stroke patients.