Assessing the effectiveness of biofeedback therapy in the rehabilitation of limb motor dysfunction after stroke and the influencing factors of disease-related shame

Abstract

Objective: To evaluate the effectiveness of biofeedback therapy in the rehabilitation of limb motor dysfunction after stroke and the factors influencing disease-related shame.

Methods: Medical records of 118 patients with limb motor dysfunction after stroke, treated in 521 Hospital of the Norinco Group from October 2019 to November 2022, were collected. The 56 patients in control group received conventional rehabilitation training, while the other 62 patients in observation group received electromyographic biofeedback therapy in addition to conventional treatment. The therapeutic effects of both groups were evaluated and compared after 4 weeks of treatment. Changes in FMA (Fugl-Meyer Motor Function Assessment Scale), mRS (Modified Rankin Scale), ADL (Activities of Daily Living Scale), and SSS (Stroke Stigma Scale) were compared before and after treatment. Multivariate logistic regression analysis was used to analyze the factors influencing disease-related shame after treatment. The effectiveness of risk factors in predicting disease-related shame was analyzed using receiver operating characteristic (ROC) curves.

Results: Upon intervention, significant gains were noted in FMA and ADL scores, with reductions in mRS and SSS (P<0.0001). After 4 weeks, the observation group showed higher FMA and ADL scores and lower mRS and SSS (P<0.0001 for FMA and ADL; P<0.05 for mRS and SSS). Logistic regression identified age ≥60 (OR 8.045, P<0.001), income <4000 yuan (OR 0.187, P=0.002), and pretreatment ADL (OR 0.047, P<0.001) as predictors of disease-related shame. The AUC for age, household monthly income, and pretreatment ADL score were 0.595 (P=0.089), 0.608 (P=0.053), and 0.750 (P<0.001), respectively, demonstrating pretreatment ADL score as the most accurate predictor of disease-related shame.

Conclusions: Electromyographic biofeedback therapy has a significant effect on the rehabilitation of stroke patients, especially on motor recovery and activities of daily living. Age, monthly family income and pre-treatment ADL scores are key factors influencing disease-related shame.

Keywords: Biofeedback therapy; disease-related shame; limb motor dysfunction; rehabilitation; stroke.

Figure 1

Changes in FMA and mRS scores before and after treatment in patients. A. Changes in FMA scores before and after treatment in control group and observation group. B. Changes in mRS scores before and after treatment in control group and observation group. Note: nsP>0.05, ****P<0.0001; FMA, Fugl-Meyer Motor Function Assessment Scale; mRS, Modified Rankin Scale.

Figure 2

Changes in ADL and SSS scores before and after treatment in patients. A. Changes in ADL scores before and after treatment in control group and observation group. B. Changes in SSS scores before and after treatment in control group and observation group. Note: nsP>0.05, *P<0.05, ****P<0.0001; ADL, Activities of Daily Living Assessment Scale; SSS, Stroke Stigma Scale.

Figure 3

ROC curve of age, monthly household income, and pre-treatment ADL score in predicting patient’s disease-related shame. Note: ADL, Activities of Daily Living Assessment Scale; ROC, Receiver Operating Characteristic Curve.