头皮针联合肌电生物反馈电刺激治疗偏瘫足下垂疗效及对步行功能的影响

目的研究头皮针联合肌电生物反馈电刺激治疗对脑卒中偏瘫后足下垂患者的临床疗效及对步行功能影响。方法选取2016年1月—2019年8月于医院康复中心治疗的脑卒中恢复期患者,随机分为观察组与对照组,每组50例。观察组患者给予头皮针与肌电生物反馈电刺激联合治疗,同时进行常规康复训练。对照组仅给予常规康复训练。观察两组患者治疗前后Brunnstrom运动功能分期、Holden步行功能分级、Barthel指数评分、胫骨前肌与腓肠肌表面肌电信号变化及治疗后两组踝背屈角度障碍情况。结果治疗后观察组VI期及V期占比分别高于对照组(P<0.05);治疗后观察组Ⅰ、Ⅱ、Ⅲ、Ⅳ期占比分别低于对照组(P<0.05)。治疗后观察组中Holden步行功能分级5级与4级占比分别高于对照组(P<0.05);治疗后观察组中1级、2级、3级占比分别低于对照组(P<0.05)。治疗后观察组Barthel指数评分高于对照组及本组治疗前(P<0.05)。治疗后观察组胫骨前肌与腓肠肌肌电信号均高于对照组及本组治疗前(P<0.05)。治疗后观察组踝背屈功能障碍总治疗有效率88.00%(44/50)明显高于对照组68.00%(34/50)。结论头皮针与肌电生物反馈电刺激联合治疗能显著提高脑卒中偏瘫后足下垂患者运动功能、步行功能及独立生活能力,使肌群活动能力增强,同时提升踝背屈功能障碍治疗有效率。

Effect of Scalp Acupuncture Combined with Electromyographic Biofeedback Electrical Stimulation on Walking Function in Patients with Hemiplegic Foot-drop

Objective To investigate the effect of scalp acupuncture combined with electromyographic biofeedback electrical stimulation on walking function in patients with hemiplegic foot-drop.Methods Patients with convalescent stroke treated in rehabilitation center of hospital from January 2016 to August 2019 were randomly divided into observation group(n=50)and control group(n=50).Control group received the routine rehabilitation training.Based on this,the observation group received the scalp acupuncture combined with electromyographic biofeedback electrical stimulation.The Brunnstrom motor function staging,Holden walking function grading,Barthel index score,anterior tibialis and gastrocnemius muscle EMG signal changes and dorsiflexion angle obstruction were observed.Results After treatment,the proportion of stage VI and V in the observation group was higher than that in the control group(P<0.05).The proportion of stageⅠ,Ⅱ,ⅢandⅣin the observation group was lower than that in the control group(P<0.05).After treatment,the percentage of Holden walking function classification in grade 5 and grade 4 was higher in the observation group than that in the control group(P<0.05),and the proportion of grade 1,2,and grade 3 in the observation group was lower than that of the control group(P<0.05).After treatment,the Barthel index score of the observation group was increased and was higher than that of the control group(P<0.05).EMG signals of tibialis anterior muscle and gastrocnemius muscle in observation group were increased and were higher than those of the control group(P<0.05).After treatment,the total effective rate of the observation group was significantly higher than that of the control group88.00%(44/50)vs 68.00%(34/50)].Conclusion Application of scalp acupuncture combined with electromyographic biofeedback electrical stimulation can significantly improve the motor function,walking function and independent living ability of patients with hemiplegic foot-drop,which can also enhance the activity of muscle groups,and improve the treatment efficiency of ankle dorsiflexion dysfunction.