Morphological and functional changes of the tibialis anterior muscle following combined mirror visual feedback and electromyographic biofeedback in poststroke patients: A randomized trial.

OBJECTIVE To investigate the morphological and functional changes of the tibialis anterior muscle following mirror visual feedback (MVF) combined with electromyographic biofeedback (EMG-BF) in poststroke patients. DESIGN A total of 46 poststroke patients were randomly divided into three groups: an MVF+EMG-BF group, an MVF group, and a control group. The MVF+EMG-BF group was treated with both MVF and EMG-BF, and the MVF group was treated with MVF alone. The morphological parameters, including the pennation angle (PA), muscle thickness (MT), and fascicle length (FL), were assessed. RESULTS After four weeks of treatment, the PA and MT values were significantly increased in the MVF+EMG-BF and MVF groups (P<0.05). The increase of these values in the MVF+EMG-BF group were significantly greater than that for both metrics in the MVF and control groups (P<0.05), and those in the MVF group were greater than those in the control group (P<0.05). There was no significant difference in the FL value among the three groups as a result of the treatment. After the treatment, the neurological functions were all increased in three groups (P<0.05). CONCLUSIONS A combination of MVF and EMG-BF appears to be an effective therapy for improving the motor function of the tibialis anterior muscle in poststroke patients. CLINICAL TRIAL REGISTRATION NUMBER ChiCTR1800017050.