针灸联合肌电生物反馈对脑卒中足下垂患者身体平衡功能、步行能力及日常生活活动能力的影响

Effects of acupuncture combined with myoelectric biofeedback on balance function,walking ability and activities of daily living in patients with stroke foot drop

目的:探讨针灸联合肌电生物反馈对脑卒中足下垂患者身体平衡功能、步行能力及日常生活活动能力的影响。方法:回顾性选取2022年1月到2023年7月合肥市第一人民医院神经内科和康复科收治的100例脑卒中足下垂患者作为研究对象,按照治疗方法分为肌电生物反馈组(47例)和联合组(53例,针灸联合肌电生物反馈),比较两组痉挛程度[采用临床痉挛指数(CSI)评估]、身体平衡功能[采用Berg平衡量表(BBS)评估]、踝关节活动度(ROM)[主动背伸度、主动跖屈度、主动内翻度]、血液流变学指标[血浆粘度(PV)、血小板聚集率(PAR)、红细胞比容(Hct)]、步行能力[步频、步幅、患侧摆动相、患侧支持相]和日常生活活动能力[采用改良Barthel指数(MBI)评估]。结果:治疗后,联合组CSI评分低于肌电生物反馈组,BBS评分高于肌电生物反馈组(P<0.05);治疗后,联合组主动背伸度高于肌电生物反馈组,主动跖屈度、主动内翻度低于肌电生物反馈组(P<0.05);治疗后,联合组PV、PAR、Hct水平低于肌电生物反馈组(P<0.05);治疗后,联合组步频、步幅、患侧摆动相、患侧支持相水平高于肌电生物反馈组(P<0.05);治疗后,联合组MBI评分高于肌电生物反馈组(P<0.05)。结论:针灸联合肌电生物反馈治疗脑卒中足下垂患者的效果显著,可有效改善痉挛程度、身体平衡功能、踝关节ROM以及血流循环,提高步行能力以及日常生活能力。.

Objective To explore the effects of acupuncture combined with myoelectric biofeedback on balance function,walking ability and activities of daily living in patients with stroke foot drop.Methods A total of 100patients with stroke foot drop admitted to the Department of Neurology and Rehabilitation of Hefei First People's Hospital from January 2022to July 2023were retrospectively enrolled as the research objects.According to different treatment methods,they were divided into myoelectric biofeedback group(47cases)and combination group(53cases,acupuncture combined with myoelectric biofeedback).The spasm degree[clinical spasm index(CSI)],balance function[Berg Balance Scale(BBS)],ankle range of motion(ROM,including active dorsiflexion,plantar flexion and varus),hemorheology indexes[plasma viscosity(PV),platelet aggregation rate(PAR),hematocrit(Hct)],walking ability[stride frequency,stride,swinging phase and support phase on affected side]and activities of daily living[Modified Barthel Index(MBI)]were compared between the two groups.Results After treatment,CSI score in combination group was lower than that in myoelectric biofeedback group,while BBS score was higher than that in myoelectric biofeedback group(P<0.05).After treatment,active dorsiflexion in combination group was higher than that in myoelectric biofeedback group,while active plantar flexion and varus were lower than those in myoelectric biofeedback group(P<0.05).After treatment,levels of PV,PAR and Hct in combination group were lower than those in myoelectric biofeedback group(P<0.05).After treatment,stride frequency,stride,swinging phase and support phase on affected side in combination group were higher than those in myoelectric biofeedback group(P<0.05).After treatment,MBI score in combination group was higher than that in myoelectric biofeedback group(P<0.05).Conclusion Curative effect of acupuncture combined with myoelectric biofeedback is significant in patients with stroke foot drop,which can effectively improve spasm,balance function,ankle ROM,blood circulation,walking ability and the ability to live daily.