表面肌电图指导的针刺治疗对脑卒中恢复期足下垂患者积分肌电值及下肢运动功能的影响

The effect of surface electromyography-guided acupuncture on integrated electromyography values and lower limb motor function in patients with foot drop during stroke recovery

摘要:

目的 探究表面肌电图（sEMG）指导的针刺治疗对脑卒中恢复期足下垂患者积分肌电值及下肢运动功能的影响。方法 选取2022年3月—2024年3月浙江中医药大学附属杭州市中医院接收的100例脑卒中恢复期足下垂患者，按信封抽签法随机分为常规组与sEMG组，每组50例。常规组给予常规内科治疗和康复训练，sEMG组在常规组的基础上给予sEMG指导的针刺治疗。比较两组治疗前后的疗效、积分肌电值、运动能力、心理状况及生活质量。结果 sEMG组治疗有效率高于常规组（P <0.05）。sEMG组治疗前后胫骨肌、腓骨肌、腓肠肌的积分肌电值的差值均高于常规组（P <0.05）。sEMG组治疗前后Berg平衡量表、Fugl-Meyer、功能性步行量表评分的差值均高于常规组（P <0.05）。两组治疗前、治疗2周、治疗4周的心理状态评估量表（MSSNS）、医院焦虑抑郁情绪测量表（HADS）评分比较，采用重复测量设计的方差分析，结果 ①不同时间点MSSNS、HADS评分比较，差异有统计学意义（P <0.05）；②两组MSSNS、HADS评分比较，差异有统计学意义（P <0.05），sEMG组的MSSNS、HADS评分均低于常规组；③两组MSSNS、HADS评分变化趋势比较，差异有统计学意义（P <0.05）。sEMG组治疗前后生命质量评价量表评分的差值均高于常规组（P <0.05）。结论 sEMG指导的针刺治疗对脑卒中恢复期足下垂患者积分肌电值及下肢运动功能的影响较为显著。

Abstract:

Objective To explore the impact of surface electromyography (sEMG) guided acupuncture on the integrated electromyography values and lower limb motor function in patients with foot drop during the recovery phase of stroke.Methods One hundred patients with foot drop during the stroke recovery phase were selected from Hangzhou Traditional Chinese Medicine Hospital between March 2022 and March 2024. They were randomly divided into a conventional group (n =50) and an sEMG group (n =50) using an envelope drawing method. The conventional group received standard medical treatment and rehabilitation training, while the sEMG group received sEMG-guided acupuncture in addition to the conventional treatment. The therapeutic effects, integrated electromyography values, mobility, psychological status, and quality of life were compared between the groups before and after treatment.Results Comparison of the effectiveness between the sEMG group and the conventional treatment group showed statistically significant differences by chi-square test (P <0.05), with higher treatment effectiveness in the sEMG group than the conventional group (P <0.05). Differences in the changes of integrated electromyographic values of tibialis anterior, peroneus longus, and gastrocnemius muscles before and after treatment between the sEMG group and the conventional group were statistically significant (P <0.05). The sEMG group exhibited higher differences in electromyographic values compared to the conventional group (P <0.05). Differences in Berg Balance Scale (BBS), Fugl-Meyer Assessment (FMA), and Functional Ambulation Category (FAC) scores before and after treatment between the two groups were statistically significant (P <0.05), with higher scores in the sEMG group (P <0.05). Analysis of repeated measures variance for MSSNS and HADS scores at baseline, 2 weeks, and 4 weeks showed significant differences (P <0.05). Comparison between groups also showed significant differences in MSSNS and HADS scores (P <0.05), with lower scores in the sEMG group. Trends in MSSNS and HADS score changes differed significantly between the two groups (P <0.05). Differences in Short Form Health Survey (SF-36) score changes before and after treatment between the sEMG group and the conventional group were statistically significant (P <0.05), with higher SF-36 scores in the sEMG group (P <0.05).Conclusion sEMG-guided acupuncture significantly affects integrated electromyography values and lower limb motor function in patients with foot drop during the stroke recovery phase.