痉挛型偏瘫脑性瘫痪患儿表面肌电特征

Features of Surface Electromyographic Signal in Children with Hemiplegic Cerebral Palsy

目的探讨痉挛型偏瘫脑性瘫痪(脑瘫)患儿肱二头肌、股四头肌在最大自主等长收缩(MIVC)过程中的表面肌电图(sEMG)的特征变化。方法采用患、健侧自身对照试验方法设计。选择2008年9月-2010年7月在广州市康复训练中心进行康复的痉挛型偏瘫脑瘫患儿11例。其中男5例,女6例;年龄(10.09±2.47)岁。采用FexComp型表面肌电仪及Ag/Agcl表面电极,在康复训练前对受试者进行测试,采样时令所有受试者保持相同姿势。将EMG的表面电极固定于其双侧肱二头肌、股四头肌体表上,在进行肘关节屈肌、膝关节伸肌MIVC时,同步记录其健、患侧肱二头肌、股四头肌的表面肌电信号,并进行频域特征量化分析,包括中位频率(MF)及平均功率频率(MPF)。结果采用SPSS 13.0软件进行统计学处理。结果在MIVC状态下,痉挛型偏瘫脑瘫患儿健侧肱二头肌、股四头肌MPF值均明显大于患侧(P<0.01,0.05),健、患侧肱二头肌、股四头肌的MF值比较,差异均无统计学意义(Pa>0.05)。患儿健侧功率谱sEMG信号明显强于患侧。结论痉挛型偏瘫脑瘫患儿肱二头肌、股四头肌存在sEMG信号异常,提示表面肌电仪对神经肌肉系统功能状态的评价具有实用价值。

Objective To explore the surface electromyography （sEMG） characteristics of biceps brachii and quadriceps during maximum isometric voluntary contraction（MIVC） in children with hemiplegic cerebral palsy. Methods Self - control design significance test was used in 11 children with hemiplegic cerebral palsy [ 5 male and 6 female;aged （10.09 ＋ 2.47 ） years ] in Rehabilitation Center of Guangzhou from Sep. 2008 to Jul. 2010. The FexComp EMG machine and Ag/Agcl electrodes were used. All subjects were measured before the rehabilitation training and took the same posture. Surface electrodes were applied on the skin of both biceps brachii and quadriceps. During the elbows and knees MIVC, the surface electromyograms of the biceps brachii and quadriceps were recorded. The parameters were analyzed in the fre- quency domain quantificationally, including mean power frequency（MPF） and median frequency（MF）. SPSS 13.0 statistical analysis software was used to process data. Results During MIVC, the biceps brachii and quadriceps of the intact side gave a stronger MPF than the affected side（P 〈 0.01,0.05 ） ,but the differences of MF were not significant（ Pa 〉 0.05 ）. The sEMG signals in the power spectrum of the healthy side were much stronger than the affected side. Conclusions The sEMG of biceps brachii and quadriceps in children with hemiplegic cerebral palsy is abnormal. Electromyographic analysis can provide a satisfactory evaluation of the muscle function.