中风康复运动中肌肉异常耦合分析

Analysis of Abnormal Muscular Coupling During Rehabilitation after Stroke

本文针对中风康复患者运动功能障碍相关的神经肌肉异常耦合和功能评价问题,研究有效的肌间一致性分析方法及指标,探索神经肌肉系统的振荡联系和中风运动功能障碍产生的病理机制,建立基于肌电信号的肌肉功能状态评价标准。首先基于一致性分析方法,对比分析中风患者运动过程中健侧、患侧上肢拮抗肌肌电间的一致性特征;在此基础上利用Z变换显著一致性面积指标量化描述健侧、患侧肌电信号在各功能频带内的耦合性差异;进一步利用动态肌间一致性分析探究肌间一致性与运动任务的关系。通过对中风患者健侧、患侧上肢肘关节屈伸运动中肌间一致性的分析,得到以下结论:中风运动功能障碍患者健侧、患侧肌间一致性均与运动任务相关,而在患侧运动过程中beta频段肌间一致性相对于健侧存在明显缺失,此外beta段肌间一致性与Fugle-Meyer量表具有相关性,表明beta段肌间一致性可以作为辅助评价患者运动功能状态的指标。

For the questions of deeply researching abnormal neuromuscular coupling and better evaluating motor function of stroke patients with motor dysfunction,an effective intermuscular coherence analysis method and index are studied to explore the neuromuscular oscillation and the pathomechanism of motor dysfunction,based on which an assessment standard of muscle function is established.Firstly,the contrastive analysis about the intermuscular coherence of antagonistic muscle of affected and intact upper limbs of stroke patients was conducted.Secondly,a significant indicator of Fisher＇s Z-transformed coherence significant indicator was defined to quantitatively describe the coupling differences in certain functional frequency domain between surface electromyogram（sEMG）of affected and intact sides.Further more,the relationship between intermuscular coherence and motor task was studied.Through the analysis of intermuscular coherence during elbow flexion-extension of affected and intact sides,we found that the intermuscular coherence was associated with motor task and the stroke patients exhibited significantly lower betaband intermuscular coherence in performing the task with their affected upper limbs.More conclusion can be drawn that beta-band intermuscular coherence has been found concerned with Fugle-Meyer scale,which indicates that betaband intermuscular coherence could be an index assisting in evaluating motor function of patients.