脑卒中躯干肌旋转肌群电生理研究

An electrophysiologic study on sEMG of trunk rotaory muscles in stroke patients

目的:本实验利用表面肌电图收集躯干旋转肌群的肌电信号,加以处理分析,具体研究偏瘫患者腹内斜肌、背阔肌、腹外斜肌、腰竖脊肌、胸竖脊肌在躯干等轴旋转动作中的改变,揭示其改变的可能机制及临床意义。方法:重偏瘫患者10例,轻偏瘫患者8例,正常人7例,收集双侧腹内斜肌、背阔肌、腹外斜肌、腰竖脊肌、胸竖脊肌在放松坐位、左旋45°位、右旋45°的肌电信号。结果:对数据进行标准化处理后,背阔肌三组之间比较重偏瘫患者健侧肌肉向健侧旋转(GRG)与正常人之间有显著性差异(P<0.05)。重偏瘫患者患侧肌肉向患侧旋转(BRB)有较正常人减少的倾向(P=0.229)。三组之间腹内斜肌比较重偏瘫患者与正常人的GRG、BRB有显著性差异(P<0.05)。正常人、重偏瘫患者、轻偏瘫患者的双侧腹外斜肌、腰竖脊肌、胸竖脊肌的GRG、BRB等无明显差异。结论:正常人背阔肌及腹内斜肌在躯干向同侧旋转时表现出较大的主动性,腹外斜肌及胸大肌、腰竖脊肌及胸竖脊肌在旋转中未表现出方向上的主动性。与正常人比,重偏瘫患者双侧背阔肌及腹内斜肌肌电活动降低,且均未表现出方向上的主动性。轻偏瘫患者与正常人无明显差异。重偏瘫患者与轻偏瘫患者腹外斜肌、腰竖脊肌及胸竖脊肌在旋转中的表现与正常人无明显差异。

Objective： By using surface EMG to collect data of rotatory muscles and to study the presentation of bilateral internal oblique, external oblique, latissimus dorsi, lumber erector spinae, thoracic erector spinae of normals and hemiplegia and hemiparesis in trunk rotation,and to clarity the clinical sense. Method： Ten hemiplegias, 8 hemiparesis and 7 normals are involved. The EMG signals of bilateral internal oblique,external oblique,latissimus dorsi,lumber erector spinae,thoracic erector spinae were collected in relaxing sitting position, upsitting to left rotatory 45 degree position and upsitting to right rotatory 45 degree position. Result： There is significant difference of latissimus dorsi＇s GRG（healthy muscle turning to healthy side） between normals and hemiplegia（P=0.047）. There is decreasing incline of latissimus dorsi＇s BRB （paralysed muscle turning to the paralysed side） of hemiplegia when compared with normals （P=0.229）. There is significant difference of internal oblique＇s GRG,BRB between normals and hemiplegia.There is no difference when compared the EMG presentation of external oblique, lumber erector spinae and thoracic erector spinae of both sides between normals and hemiplegia and hemiparesis.Conclusion：Compared with normals,both internal oblique and latissimus dorsi of both sides of hemiplegia have less activity.There is no difference of external oblique,lumber erector spinae, thoracic erector spinae and between normals, hemiplegia and hemiporesis.