The effects of walking training assisted by electromyographic biofeedback on motor recovery of the lower limb of subacute stroke patients with foot drop

Abstract

Objective To explore the effects of walking training assisted by electromyographic biofeedback (EMGBF) on the lower limb function of subacute stroke patients with foot drop. Methods Forty subacute stroke patients with foot drop were randomly divided into an EMGBF training group (n =20 ) and a routine rehabilitation training group ( n =20 ).Both groups received routine rehabilitation training.The EMGBF training group also received walking training assisted by three stages of EMGBF.The subjects were treated for 40 min twice per day,5 days a week for 6 weeks.Clinical and functional evaluations such as surface electromyogram (sEMG) signals from the anterior tibial muscle,active ankle dorsiflexion range of motion ( AROM ),scores on the modified Ashworth scale (MAS),results of the modified Lovett manual muscle test (mMMT),pace and step length,Berg balance scale (BBS) scores,Fugl-Meyer movement function scale (FMA) assessments,modified Barthel index (MBI) scores and Holden walking function test results were observed before treatment,after 6 weeks of treatment and at follow-up 6 weeks after the end of treatment. Results Before treatment there was no significant difference between the two groups.There were significant differences in all of the assessment results in the EMGBF training group after treatment compared with before treatment and compared with the routine rehabilitation training group after treatment.At followup 6 weeks after training,average pace (69.75 ± 35.09 m/min),step length (60.98 ± 14.09 cm),FMA score (32.5 ± 6.34 ) and MBI score (88.65 ± 14.13 ) in the EMGBF training group were all significantly better than in the routine rehabilitation group.At follow up,5 patients in the EMGBF training group achieved grade 5 in the Holden walking function test versus only 1 patient in the routine rehabilitation group. Conclusion Walking training assisted by EMGBF is effective in improving lower limb motor function in subacute stroke patients with foot drop. Key words: Cerebrovascular accidents; Gait disorders, neurologic; Walking; Electromyographic biofeedback