Effect of combination of botulinum toxin and electromyographic biofeedback therapy on post-stroke patients with lower limb muscle spasticity

Abstract

Purpose: To investigate the clinical effect of combined use of botulinum toxin type A and electromyographic biofeedback therapy (EMGBFT) on post-stroke patients with lower limb muscle spasticity. Methods: The data of 91 post-stroke patients with lower limb muscle spasticity who were admitted to Shanghai Seventh People’s Hospital (January 2020 -January 2021) were retrospectively analyzed, and they were divided into control group (COG, n = 45) and study group (STG, n = 46) based on the treatments given. All patients received conventional rehabilitation and training. Patients in COG were treated with EMGBFT, whereas those in STG received botulinum toxin type A as well as EMGBFT. The parameters determined in the two groups were degree of spasticity, lower limb motor function [3m-Timed Up and Go (3m - TUG) and 10m - Walk Test (10 m - WT)], active range of motion (AROM) of ankle dorsiflexion, ability of daily living (based on Barthel Index, BI), and adverse reactions before and after treatment. Results: The effectiveness of the treatments on spasticity was higher in STG than in COG (p < 0.05). After treatment, the times taken for 3m-TUG and 10m-WT were significantly shorter in STG than in COG (p < 0.05). The AROM of patients in both groups was expanded, but the expansion was significantly greater in STG than in COG (p < 0.05). Conclusion: Combined therapy using botulinum toxin and EMGBFT effectively relieved lower limb muscle spasticity of post-stroke patients, and also improved their lower limb motion function and daily living ability. Thus, the combined therapy provided better management of lower limb spasticity. However, further clinical trials are required prior to its adoption in clinical practice.