脑卒中下肢肌肉痉挛状态患者不同收缩状态下的表面肌电特征分析

目的 观察脑卒中下肢肌肉痉挛状态患者不同收缩状态下的表面肌电特征,何种方式下评估最佳,为合理治疗提供电生理依据.方法 选择30例脑卒中患者对其腓肠肌进行改良Ashworth分级(MAS)评估的同时,记录不同状态下偏瘫侧腓肠肌内、外侧头的表面肌电信号.结果 静息状态、被动牵伸状态:腓肠肌内、外侧头AEMG值、RMS值均与MAS呈正相关(P<0.001);最大等长收缩状态:腓肠肌内、外侧头RMS与MAS呈正相关(P<0.05),AEMG值与MAS值间差异无统计学意义(P>0.05);三种状态下测定的AEMG值、RMS值腓肠肌内、外侧头无差异.结论 肌肉痉挛状态的评估应在安静及被动牵伸时评估有效,康复训练及肉毒毒素治疗肠肌内、外侧头作用应一致, AEMG、RMS值均可作为肌肉痉挛状态评估的量化指标.

Objective To understand the severity of spasm and the rational treatment to provide electrophysiological basis,and the characteristics in different contracting were observed and analyzed based on surface electromyography on stroke patients with lower muscle spasticity.Methods 30 stroke patients with lower limb muscle spasticity and 10 normal people were chosen,the modified Ashworth scores of gastrocnemius muscles were evaluated and the sEMG synchronously was recorded.Results In quiescent condition and passive movement,there was a positive correlation between with MAS and the AEMG and RMS of gastrocnemius muscle(P<0.001).In maximum isometric voluntary contraction,the RMS of gastrocnemius muscles correlated with MAS(P<0.05)and AEMG was not(P>0.05).In different contraction,the RMS,AEMG of gastrocnemius muscle make no difference.Conclusion That is remind us that the sEMG can present the electrical activities in quiescent condition and passive movement of gastrocnemius muscle,which may help for spasticity and clinical treatment.The AEMG value can be used as a quantitative index.