Effects of Limb Coordination Device Combined with VR Training on Gait Balance and Surface Electromyography in Patients with Acute Cerebral Infarction after Intracranial Endovascular Therapy
FAN Zhenmei, WANG Chunbu, XIE Ting, GAO Fengqing
2023, 18(02):
194-200.
DOI: 10.3969/j.issn.1673-5765.2023.02.009
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Objective To investigate the effects of limb coordination device combined with virtual reality (VR) on gait balance and surface electromyography (EMG) in patients with acute cerebral infarction after intracranial endovascular therapy.
Methods Patients with acute cerebral infarction admitted to the Department of Neurology of the Second Affiliated Hospital of Xingtai Medical College from June 2019 to June 2021 were prospectively enrolled in this study. All patients received intracranial endovascular therapy and were divided into control group and observation group according to random number table method. Patients in the control group received limb coordination auxiliary device training combined with conventional training, and patients in the observation group received limb coordination auxiliary device training combined with VR training. After two months of training, the trunk impairment scale (TIS), Fugl-Meyer balance assessment score (FMA-B), Holden functional ambulation classification (FAC), modified Barthel index (MBI) were used to assess the trunk function, balance function, walking ability, and daily living ability of the patients, and the patient's three-dimensional gait parameters and surface EMG status were recorded.
Results A total of 152 patients were included in this study, with a mean age of 42.64±4.17 years old and 81 males(53.29%), and 76 cases in each group. After training, the TIS scale coordination
[(3.93±0.46) points vs. (2.88±0.25) points, P<0.001], static sitting balance [(5.63±1.35) points vs. (4.99±1.04) points, P=0.004], dynamic sitting balance score [(3.95±0.62) points vs. (3.19±0.54), P<0.001] and FMA-B score [(7.95±1.99) points vs. (7.04±1.84 points), P=0.010] in the observation group were all higher than those in the control group; the FAC level of the observation group was higher than that of the control group, and the gait speed [(52.46±4.98) cm/s vs. (48.34±4.28) cm/s,
P<0.001], stride frequency [(89.42±8.48) times/min vs. (80.47±7.96) times/min, P<0.001] and limb swing phase (38.45%±4.02% vs. 34.26%±3.87%, P<0.001) in the observation group were all higher than that in the control group; the left and right step length difference [(0.62±0.06) cm vs. (0.93±0.11) cm, P<0.001] and asymmetry index [(0.07±0.03) vs. (0.12±0.02), P<0.001]
in the observation group were all lower than that in the control group; the EMG integral values of quadriceps femoris muscle [(0.10±0.02) cm/s vs. (0.08±0.01) cm/s, P<0.001], tibialis anterior
[(0.11±0.02) cm/s vs. (0.08±0.02) cm/s, P<0.001] and gastrocnemius [(0.09±0.02) cm/s vs. (0.07±0.01) cm/s, P<0.001] in the observation group were all higher than those in the control group, while the root mean square amplitude of the quadriceps femoris muscle [(4.38±0.37) mV vs. (5.38±0.59) mV, P<0.001], tibialis anterior [(4.63±0.47) mV vs. (5.28±0.83) mV, P<0.001] and gastrocnemius [(6.37±1.02) mV vs. (8.66±1.15) mV, P<0.001] in the observation group were lower than those in the control group. The MBI score [(67.41±7.86) points vs. (61.57±6.63) points, P<0.001] of the observation group was higher than that of the control group.
Conclusion The combination of limb coordination auxiliary device and VR training is beneficial for the recovery of motor function of patients with acute cerebral infarction after intracranial endovascular therapy, can improve trunk function, balance function, walking ability and muscle tolerance of patients, as well as quality of daily life.
