Observation on efficacy of integrated neuromuscular training in treatment of patients with spastic hemiplegia of lower limbs after stroke

JING Xingquan; CHEN Wanchao; XIE Zhuopeng

doi:10.3969/j.issn.1674-3806.2025.10.09

Abstract：Objective To observe the efficacy of integrated neuromuscular training(INT)in treatment of patients with spastic hemiplegia of lower limbs after stroke.Methods One hundred patients with spastic hemiplegia of lower limbs after stroke who were admitted to Chinese People's Liberation Army Marine Corps Hospital from January 2021 to December 2024 were selected.The patients were divided into control group and observation group by using random number table method,with 50 patients in each group.The control group received conventional rehabilitation training,while the observation group received INT.The training period was 12 weeks in both groups.The surface electromyography(sEMG)indicators of lower limbs,neurological function,lower limb motor function,psychological state and quality of life were observed,and the levels of serum gamma-aminobutyric acid(GABA),neuron-specific enolase(NSE)and glutamate(Glu)were detected before and after treatment.The clinical effects were compared between the two groups.Results After treatment,the root mean square(RMS)of electrical activity signals of muscles in electromyography,the National Institutes of Health Stroke Scale(NIHSS)scores,the Clinical Spasticity Index(CSI)scores,the Hospital Anxiety and Depression Scale(HADS)scores,GABA levels,NSE levels and Glu levels in both groups were significantly lower than those before treatment,and these indicators in the observation group were significantly lower than those in the control group after treatment(P＜0.05).After treatment,the time of 10-meter walk test in both groups was significantly shortened compared with that before treatment,and the time of 10-meter walk test in the observation group was significantly shorter than that in the control group after treatment(P＜0.05).After treatment,the intramuscular electromyography(iEMG),median frequency(MF),mean power frequency(MPF),Berg Balance Scale(BBS)scores,Fugl-Meyer Assessment(FMA)scale scores,Functional Independence Measure(FIM)scores and modified Barthel Index(MBI)in the two groups were significantly elevated than those before treatment,and these indicators in the observation group were significantly higher than those in the control group after treatment(P＜0.05).The total effective rate of the observation group was higher than that of the control group(96.00%vs82.00%,χ2=5.005,P=0.025).Conclusion INT is significantly effective in treatment of patients with spastic hemiplegia of lower limbs after stroke.INT can effectively improve the neurological function,lower limb motor function and psychological state of the patients.