恢复期脑卒中患者肘屈伸肌群最大等长收缩的表面肌电图研究

Surface Electromyography Study on Maximum Isometric Contraction of Elbow Flexor and Extensor at the Convalescence Stage of Stroke Patients

目的:探讨恢复期脑卒中患者肘屈伸肌群的生物力学变化及对应的表面肌电图特征,为恢复期脑卒中患者制定康复方案提供科学依据。方法:采用Biodex-Ⅲ型等速测试仪里面“双侧等长收缩模式”对14例健康人群(健康组)及16例恢复期脑卒中患者(卒中组)进行双侧肘屈伸肌测试,用Noraxon 2400表面肌电图仪同步观察肘屈伸肌的肌电信号。结果:健康组右侧肘屈肌及伸肌的峰力矩、峰力矩体重比均高于左侧(P<0.05);右侧肱二、三头肌的积分肌电面积也高于左侧(P<0.05)。卒中组患侧肘屈肌及伸肌的峰力矩、峰力矩体重比均低于健侧,而屈伸力矩比高于健侧(P<0.05);患侧肱二、三头肌的积分肌电面积比健侧下降,而协同收缩率则明显升高(P<0.05)。与健康组比较,卒中组健侧肘屈伸肌也存在等长肌力及肌电信号的异常。结论:恢复期的脑卒中患者上肢健患侧屈伸肌都存在肌力及主动肌拮抗肌协调性的异常,制定康复方案时不应忽视加强双侧屈伸肌力量的训练。

Objective：To explore the biomechanical variation and the surface electromyography （EMG） characteristics of elbow flexor and extensor at the convalescence stage of stroke patients, in order to gain the reasonable convalescence rehabilitation programs after stroke. Methods： The Biodex multi-joint system III （the mode of isometric bilateral） was used to test 14 healthy elderly volunteers and 16 stroke patients. Surface EMG （Noraxon2400） was used to record the potentials of elbow flexor and extensor at equal pace. Results： The peak torque （PT）, peak torque/body weight （PT/BW） and the integrated EMG （iEMG） of elbow flexor and extensor on the right side were significantly higher than those on the left side in the healthy group （P〈0.05）. There were significant decreases in PT, PT/BW and the iEMG of elbow flexor and extensor on the affected side of stroke patients as compared with those on the unaffected side, and the significant increases in the flexion to extension （F/E） and the EMG co-contraction ratio on the affected of the stroke patients were observed （P〈0.05）. Besides, the abnormality in both isometric contraction and surface myoelectric signal of elbow flexor and extensor on the unaffected side of stroke group was found （P〈0.05）. Conclusion：The muscle strength and the muscle concordance of elbow flexor and extensor on both sides of stroke patients still has the abnormality at the convalescence stage after stroke. The training of elbow muscles on both sides should be enhanced.