表面肌电图在脑瘫患儿疗效评估中的应用研究

Application of surface electromyography in the assessment of rehabilitation effect in children with cerebral palsy

目的:探讨表面肌电图(sEMG)在学龄期脑瘫患儿疗效评估中的应用价值。方法:对60例痉挛型双瘫型脑瘫患儿进行综合康复治疗。治疗前后分别采用粗大运动功能测试量表(GMFM)和表面肌电仪对患儿进行测试,分析肌电积分值(iEMG)、均方根值(RMS)、平均功率频率(MPF)、中位频率(MF)、平均肌电值(AEMG)。结果:60例患儿治疗前后GMFM量表A、B、C区评分比较差异无统计学意义,治疗3个月后D、E区及总分均较治疗前明显提高(P<0.01)。60例患儿治疗3个月后功能位腓肠肌、股四头肌iEMG值均较治疗前明显下降(P<0.01),RMS、AEMG、MF及MPF值治疗前后差异无统计学意义;最大等长收缩(MIVC)状态下腓肠肌、股四头肌iEMG、RMS及AEMG值均较治疗前明显提高(P<0.01),MF及MPF值治疗前后差异无统计学意义。结论:sEMG能够定量反映肌肉功能的水平,可作为脑瘫患儿疗效评估的电生理学方法。

Objective：To explore the application value of surface electromyography （sEMG） in the assessment of school-age children with cerebral palsy. Methods：Sixty children with spastic diplegia received comprehensive rehabilitation treatment. All patients were evaluated by gross motor function measure （GMFM） scale and sEMG before and after training. Integrated electromyography （iEMG）, root mean square （RMS）, mean power frequeney（MPF） ,median frequency（MF） and average EMG （AEMG） were recorded. Results：Three months after the training, the scores of seetions A,B and C of GMFM had no statistical change,while the total scores and scores of the sections D and E were increased significantly （P〈0.01）. The iEMG values of quadriceps and gastrocnemius muscles at functional motion were decreased significantly（P〈0.01）, while the values of RMS, AEMG, MF and MPF had not significant changed, iEMG values of quadriceps and gastrocnemius muscles, RMS and AEMG were increased significantly at MIVC（P〈0.01） ;the value of MF and MPF had no statistical change. Conclusion：The sEMG measurement can reflect the states of muscle function quantitatively,and the sEMG is feasible to assess the rehabilitation effect in children with cerebral palsy.