| Stroke as a threat to human health of one of the three diseases,has a high morbidity,disability and mortality.Studies reported that 55% to 75% of hemiplegics have left upper limb disability,while the upper limb is the necessary functional structure for human to carry out daily life activities.Although the contralateral upper limb can play a compensatory role to some extent,however,the dysfunctional side of upper limb will still affect the patient’s daily life activities.Previous clinical treatment of hemiplegia in stroke patients was more tended to the traditional rehabilitation-based methods,but the treatment effects was not always ideal.With the continuous improvement of the level of rehabilitation technology,the role of mirror therapy combined with electromyography in the recovery of upper limb function in patients with hemiplegia after stroke is more and more attentioned by clinicians,but it’s clinical study and evaluation of efficacy was rare reported,and the results of the trial were also different because of the disagreement among the population,the grouping,the age,the intervention cycle,the intervention time,the observation index and the implementation plan.Objective:To investigate the role of mirror therapy combined with electromyography in the recovery of upper limb function in patients with hemiplegia after stroke.Methods:90 patients with hemiplegia after stroke were randomly divided into routine group(including 30 cases),electromyographic group(including 30cases)and combined-treatment group(including 30 cases).All patients accepted routine rehabilitation therapy according to their own situation.The electromyographic group also accepted electromyographic biofeedback therapy,and the combined-treatment group accepted mirror therapy in addition.They were assessed with Fugl-Meyer Assessment,Brunnstrom staging of hemiplegia,Functional Independence Measure Scale,the patient’s wrist dorsiflexion active range of motion and the myoelectricity of the ipsilateral forearm extensor before and after treatment.Results:Brunnstrom grading situation: before treatment,in the routine group,the cases about Ⅰ to Ⅵ level of upper limb were 4,8,11,7,0,0 respectively and about the hand is 12,8,6,4,0,0 respectively.In the electromyographic group,the cases aboutⅠtoⅥ level of upper limb were 5,7,11,7,0,0 respectively and about the hand is 11,8,6,5,0,0 respectively.In addition,in the combined-treatment group,the cases aboutⅠtoⅥ level of upper limb were4,4,12,10,0,0 respectively and about the hand is 7,7,9,7,0,0 respectively.After4 weeks of treatment,in the routine group,the cases aboutⅠtoⅥ level of upper limb were 0,1,18,9,2,0 respectively and about the hand is 0,8,15,4,3,0respectively.In the electromyographic group,the cases aboutⅠtoⅥ level of upper limb were 0,0,9,15,6,0 respectively and about the hand is 0,2,15,9,4,0respectively.In addition,in the combined-treatment group,the cases aboutⅠtoⅥ level of upper limb were 0,0,1,13,16,0 respectively and about the hand is 0,0,7,11,7,5 respectively.In terms of the myoelectricity of the ipsilateral forearm extensor,after 4weeks of training,the myoelectricity increased from the initial 20.36±9.545μV to 33.83±11.783μV in the routine group.And in the electromyographic group,the myoelectricity increased from the initial 22.08±10.175μV to51.67±17.555μV.What’s more,the myoelectricity of the combined-treatment group increased from the initial 24.65±11.207μV to 79.37±20.895μV.About the Fugl-Meyer Assessment: after 4 weeks of treatment,the score increased from the initial 22.23±11.584 points to 33.47±12.099 points in theroutine group.And in the electromyographic group,the score increased from the initial 22.20±11.469 points to 42.23±11.316 points.What’s more,the score of the combined-treatment group increased from the initial 25.57±12.461 points to 51.20±7.871 points.In terms of the patient’s wrist dorsiflexion active range of motion,after 4weeks of training,the range of motion increased from the initial 13.87±6.141°to 23.03±7.681° in the routine group.And in the electromyographic group,the range of motion increased from the initial 14.50±6.653° to 33.53±9.336°.What’s more,the range of motion of the combined-treatment group increased from the initial 16.23±7.016° to 47.43±9.698°.About the Functional Independence Measure scale: after 4 weeks of treatment,the score increased from the initial 34.63±7.582 points to46.17±10.144 points in the routine group.And in the electromyographic group,the score increased from the initial 34.63±8.036 points to 52.10±11.137 points.What’s more,the score of the combined-treatment group increased from the initial 35.20±7.946 points to 63.30±12.009 points.In terms of all the assessments,there were no significant differences between the three groups before treatment(P>0.05).After 4 weeks of treatment,the group comparison,all the indicators including the Brunnstrom motor recovery stage,Fugl-Meyer Assessment,Functional Independence Measure Scale,the patient’s wrist dorsiflexion active range of motion and the myoelectricity of the ipsilateral forearm extensor was improved(P<0.05).Comparison between groups,all the indicators of the electromyographic group was better than the routine group(P<0.05),and the combined-treatment group was better than the other two groups(P<0.05).Conclusion:1 In this study,after 4 weeks of treatment,all the indicators including the Brunnstrom motor recovery stage,Fugl-Meyer Assessment,Functional Independence Measure Scale,the patient’s wrist dorsiflexion active range of motion and the myoelectricity of the ipsilateral forearm extensor of the combined-treatment group was significantly better than the other two groupswhich indicated that mirror therapy combined with electromyographic biofeedback therapy could improve the upper limb function of the hemiplegic patients.2 The results of this study demonstrated that mirror therapy combined with electromyographic biofeedback therapy is feasible and effective for hemiplegics with 20 minutes at one time,1 time a day,and 6 times a week treatment. |
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