The role of technologies with biofeedback in afterstroke muscle strength and muscle tone correction: an open-label randomized controlled prospective study

Relevance. Stato-locomotor disorders are associated with poor quality of life and risk of premature death in afterstroke patients. Aim. To evaluate the effect of functional electrical stimulation (FES) and biofeedback (BFB) stabilometric training on muscle strength and muscle tone in the chronic period of ischemic stroke (IS) patients. Matherials and Methods. The 160 patients in the chronic period of IS were randomized into four equal groups (n=40) depending on the rehabilitation programm: 1 group of FES, 2 group using BFB-stabilometric training, 3 group of combined application of FES and BFB-stabilometric training, and 4 control group receiving the standard medical rehabilitation (MR). The follow-up period was 6 months. Muscle strength was assessed using the MRC scale, muscle tone – by the modified Ashworth scale, and patients' functional independence in daily life – by the Barthel index (BI). Results. Complex MR with the FES and BFB-stability training significantly (p <0.05) improved muscle strength: in the group with FES, thigh muscles – from 3.48±0.17 to 4.22±0.15 points (hip); in the group of FES and BFB-stability training – from 3.33±0.22 to 4.3±0.12 (hip) and from 3.18±0.14 to 3.52±0.12 points (shin). The positive statistically significant dynamics were determined by week 5 and 6 months of follow-up in groups 1 and 3 of patients and was associated with an improvement in functional independence according to the BI (p <0.05). Conclusions. The use of BFB-based methods in the MR process contributes to a recovery of motor functions and functional independence of the patient in the chronic stroke period.