肌电生物反馈结合针刺治疗脑卒中偏瘫足下垂临床疗效观察

Clinical Effect of Electromyographic Biofeedback Combined with Acupuncture in Treatment of Foot Drop in Patients with Stroke Hemiplegia

目的探讨肌电生物反馈结合针刺治疗脑卒中偏瘫足下垂患者的临床疗效。方法将63例脑卒中偏瘫足下垂患者随机分为针刺组(针刺治疗)、反馈组(肌电生物反馈治疗)和综合组(肌电生物反馈结合针刺治疗),每组21例。分别于入组前、疗程结束后进行胫骨前肌表面肌电峰值(surface electromyogram signal,sEMG)、踝关节活动度(ankel range of motion,AROM)和Fugl-Meyer下肢运动功能(FuglMeyer assessment of lower limbs,FMA-L)检测,比较3组患者治疗前后胫骨前肌功能、AROM和下肢运动功能恢复情况的差异。结果治疗前3组患者sEMG、AROM和FMA-L评分比较,差异无统计学意义(P>0.05);疗程结束后3组患者sEMG、AROM和FMA-L评分均显著升高,差异有统计学意义(P<0.05);综合组治疗前后sEMG、AROM和FMA-L评分差值均高于针刺组及反馈组,差异有统计学意义(P<0.05)。结论肌电生物反馈和针刺治疗对改善脑卒中偏瘫足下垂均有一定效果,将两者联合运用有助于提高疗效。

Objective To investigate the clinical effect of electromyographic biofeedback combined with acupuncture in the treatment of foot drop in patients with stroke hemiplegia. Methods A total of 63 patients with foot drop caused by stroke hemiplegia were randomly divided into acupuncture group, electromyographic biofeedback group, and combination group （electromyographic biofeedback plus acupuncture）, with 21 patients in each group. Surface electromyogram signal （sEMG） of the anterior tibial muscle, ankle range of motion （AROM）, and Fugl-Meyer Assessment of lower limbs （FMA-L） score were measured before enrollment and after the treatment ended, and the three groups were compared in terms of the function of the anterior tibial muscle, AROM, and recovery of the motor function of lower limbs. Results There were no significant differences in sEMG, AROM, and FMA-L score between the three groups before treatment （P〉0.05）. After the treatment ended, all three groups had significant increases in sEMG, AROM, and FMA-L score （P〈0.05）, and the combination group had significantly greater increases than the other two groups （P〈0.05）. Conclusion Both electromyographic biofeedback and acupuncture have certain clinical effect in the treatment of foot drop in patients with stroke hemiplegia, and a combination of these two therapies helps to improve the clinical outcome.