Effect Of Mirror Therapy Combined With Electromyographic Biofeedback On Balance And Walking Ability Of Hemiplegic Patients After Stroke

Objective:To observe the rehabilitation effect of 4-week mirror therapy(MT)combined with EMG-biofeedback(EMG-BF)on the balance and walking ability of hemiplegic patients,and provide a practical basis for the application of this combined training on stroke rehabilitation.Methods:48 cases of post-stroke patients(5 cases fell off,43 cases completed)were selected,according to the inclusion criteria,and were randomly divided into control group(n=11),mirror group(n=10),EMG group(n=11)and combined group(n=11).On the basis of conventional rehabilitation training,the control group was supplemented with autonomous activities,the mirror group was supplemented with MT,the electromyography group was supplemented with EMG-BF,and the combination group was supplemented with MT combined EMG-BF,30 min per day,1 time/d,6 d per week,for 4 weeks.All patients were evaluated before and after 4-week training with clinical basic scales [Fugl-Meyer Assessment of Lower Extremity(FMA-LE),Modified Ashworth Spasticity Scale(MAS),Manal Muscle Test(MMT)and Berg Balance Scale(BBS)],Biodex balancer test [Postural Stability Test(PST)and Fall Risk Test(FRT)] and walking ability tests[10-meter Maximum Walking Speed Test(10m MWST),“Timed-Up and Go” Test(TUGT)and6-Minute Walking Test(6MWT)].Results:(1)Baseline dataThere was no statistically significant difference in the comparison of basic data and indicators among the four groups before training(P>0.05).(2)Clinical basic scaleAfter 4-week training,the FMA-LE and BBS scores were significantly improved(P<0.05)in the control and mirror groups,and were extremely significantly improved(P<0.01)in the EMG and combined groups;all four groups showed an improvement trend in MAS and MMT,which were improved significantly only in the combined group(P<0.05).Comparison among groups,the FMA-LE score in the combined group was significantly better than that in the mirror and EMG groups(P<0.05),and extremely significantly better than that in the control group(P<0.01);the FMA-LE score in the EMG group was significantly better than that in the control group(P<0.05);only the BBS score in the combined group was significantly better than that in the control group(P<0.05);there was no statistically significant difference in MAS and MMT among the four groups(P >0.05).(3)Biodex balancer testAfter 4-week training,the PST results of the control,mirror and EMG groups were significantly improved(P<0.05);the FRT result of the combined group was significantly improved(P<0.05),and the PST results were extremely significantly improved(P<0.01).Comparison among groups,Overall Stability Index and Anterior/Posterior Stability Index of the combined group were significantly better than those of the mirror and EMG groups(P<0.05),and extremely significantly better than that of the control group(P<0.01);Anterior/Posterior Stability Index of the EMG group was significantly better than that of the control group(P<0.05);Overall Stability Index and Anterior/Posterior Stability Index of the mirror group were significantly better than those of the control group(P<0.05);only Medial/Lateral Stability Index of the combined group was significantly better than that of the control group(P<0.05);there was no statistically significant difference in FRI among the four groups(P>0.05).(4)Walking ability testAfter 4-week of training,10 m MWST,TUGT and 6MWT were significantly improved in the control,mirror and EMG groups(P<0.05);in the combined group,6MWT was significantly improved(P<0.05),and all other indexes were extremely significantly improved(P<0.01).Comparison between groups,10 m MWST of the combined group was significantly better than that of the mirror and EMG groups(P<0.05),and extremely significantly better than that of the control group(P<0.01);10m MWST of the EMG and mirror groups was significantly better than that of the control group(P<0.05);only TUGT of the combined group was significantly better than that of the control group(P<0.05);there was no statistically significant difference in 6MWT among the four groups(P>0.05).Conclusion:Conventional rehabilitation training,mirror therapy,EMG-biofeedback and mirror combined with EMG-biofeedback can improve the lower limb balance and walking ability of hemiplegic patients,and the combined training is more effective in improving the static balance and walking speed.