Effect of extracorporeal shock wave combined with myoelectric biofeedback on foot drop after stroke

doi:10.3877/cma.j.issn.2095-123X.2023.05.005

Abstract

Abstract:

Objective

To investigate the effect of extracorporeal shock wave therapy (ESWT) combined with electromyography biofeedback therapy (EMG-BFT) on foot drop after stroke.

Methods

Ninety patients with poststroke foot drop admitted to the Rehabilitation Medicine Department of Enshi Tujia and Miao Autonomous Prefecture Central Hospital from May 2019 to May 2022 were randomly divided into 3 group using a random number table method: observation group, BFT group, and control group, 30 patients in each group. The control group received routine rehabilitation treatment, the BFT group received EMG-BFT on the basis of the control group, and the observation group received ESWT combined with EMG-BFT on the basis of the control group. All 3 groups were treated for 4 weeks. The ankle dorsiflexion mobility, comprehensive spasticity scale (CSS) and Fugl-Meyer motor function scale lower extremity (FMA-LE) and surface electromyography were performed before and after 4 weeks of treatment for all patients. The improvement of ankle range of motion, ankle spasms, lower limb motor function, and key muscle surface electromyography were observed.

Results

The differences in ankle mobility, CSS score, FMA-LE score, anterior tibial muscle iEMG, gastrocnemius muscle iEMG and foot dorsiflexion CR before treatment in the 3 groups were not statistically significant (P>0.05). After treatment, ankle mobility, CSS score, and FMA-LE score in all three groups improved significantly compared with those before treatment (P<0.05); the results of tibialis anterior muscle iEMG, gastrocnemius muscle iEMG and foot dorsiflexion CR in patients in the observation group and BFT group improved significantly compared with those before treatment (P<0.05), and after treatment, the ankle mobility, CSS score, anterior tibialis iEMG, and foot dorsiflexion CR were better in the observation group than in the BFT group and the control group (P<0.05).

Conclusion

The combined use of ESWT and EMG-BFT was significantly more effective in improving the active and passive mobility of the affected ankle joint, improving spasticity, and improving motor function of the lower extremity than the absence of both treatments or the use of EMG-BFT alone.

Key words: Extracorporeal shock wave, Electromyography biofeedback, Stroke, Foot drop

Jiaquan Liao, Bo Wu, Changmin Tang. Effect of extracorporeal shock wave combined with myoelectric biofeedback on foot drop after stroke[J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2023, 13(05): 286-292.

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References 23

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组别	例数	性别		年龄（岁，Mean±SD）	病程（d，Mean±SD）	病变部位		偏瘫侧别		Brunnstrom分期
组别	例数	男	女	年龄（岁，Mean±SD）	病程（d，Mean±SD）	脑梗死	脑出血	左侧	右侧	Brunnstrom分期
对照组	26	14	12	48.76±8.27	39.65±14.72	17	9	15	11	2.92±1.01
BFT组	30	21	9	48.87±10.29	38.43±13.52	16	14	16	14	3.13±0.86
观察组	29	17	12	49.86±9.79	35.76±14.35	18	11	13	16	3.24±0.87
χ²/F值		1.651		0.114	0.551	0.921		0.954		0.851
P值		0.438		0.892	0.579	0.631		0.621		0.431

组别	例数	性别		年龄（岁，Mean±SD）	病程（d，Mean±SD）	病变部位		偏瘫侧别		Brunnstrom分期
组别	例数	男	女	年龄（岁，Mean±SD）	病程（d，Mean±SD）	脑梗死	脑出血	左侧	右侧	Brunnstrom分期
对照组	26	14	12	48.76±8.27	39.65±14.72	17	9	15	11	2.92±1.01
BFT组	30	21	9	48.87±10.29	38.43±13.52	16	14	16	14	3.13±0.86
观察组	29	17	12	49.86±9.79	35.76±14.35	18	11	13	16	3.24±0.87
χ²/F值		1.651		0.114	0.551	0.921		0.954		0.851
P值		0.438		0.892	0.579	0.631		0.621		0.431

组别	例数	治疗前	治疗后	t值	P值
对照组	26	10.85±2.57	13.69±2.23	-4.341	<0.001
BFT组	30	10.57±2.49	17.10±2.69^a	-10.919	<0.001
观察组	29	10.31±3.22	20.14±2.60^ab	-12.050	<0.001
F值		0.254	53.110
P值		0.776	<0.001

组别	例数	治疗前	治疗后	t值	P值
对照组	26	10.85±2.57	13.69±2.23	-4.341	<0.001
BFT组	30	10.57±2.49	17.10±2.69^a	-10.919	<0.001
观察组	29	10.31±3.22	20.14±2.60^ab	-12.050	<0.001
F值		0.254	53.110
P值		0.776	<0.001

组别	例数	治疗前	治疗后	t值	P值
对照组	26	48.38±5.43	52.35±3.37	-3.357	0.003
BFT组	30	49.47±4.54	56.27±2.77^a	-7.597	<0.001
观察组	29	50.17±4.17	59.69±3.44^ab	-12.520	<0.001
F值		0.996	36.176
P值		0.374	<0.001

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