脑卒中患者坐站起立试验下大腿肌群表面肌电图信号特征研究

The surface electromyography characteristics in patients with stroke under standing up test

目的观察脑卒中患者坐站起立试验过程中大腿肌群表面肌电图(sEMG)信号变化特征,为脑卒中患者坐站过程中预防跌倒提供电生理理论基础。方法选取20例脑卒中患者(脑卒中组)与20例健康同龄成年人(正常组),对两组受试者行坐站起立试验时的大腿股直肌与股二头肌sEMG信号参数进行比较分析。结果脑卒中组中患侧大腿股直肌、股二头肌的AEMG值均明显低于健侧,差异有统计学意义(t分别=3.44、4.66,P均<0.05),但健侧和患侧的屈肌拮抗比(CR)比较,差异无统计学意义(t=1.31,P>0.05)。脑卒中组患侧大腿股直肌、股二头肌的AEMG值与正常组左侧、右侧比较,差异均无统计学意义(t分别=0.15、-2.02;0.34、-3.25,P均>0.05)。但脑卒中组患侧CR比正常组左侧和右侧CR低,差异有统计学意义(t分别=-2.50、-3.27,P均<0.05)。结论脑卒中患者的健患侧肢体之间存在不对称肌肉收缩,健侧下肢肌群过度代偿激活的情况,揭示了由于脑卒中导致的感觉运动信息整合的缺失和姿势控制灵活性的丧失,脑卒中患者应加强患侧下肢肌群的激活以维持坐站过程中的姿势控制平衡,避免跌倒。

Objective To observe the change characteristics of sEMG signal in lower extremity muscle group in patients with stroke during standing up test,so as to provide electrophysiological theoretical basis for prevention of fall in cerebral stroke patients during standing up test.Methods Totally 20 healthy adults of the similar age(normal group)and 20 stroke patients(stroke group)were selected to compare and analyze the signal parameters of rectus femoris and biceps femoris sEMG during the standing up test.Results In the stroke group,AEMG values of rectus femoralis and biceps femoralis were significantly lower than those of the healthy side,and the differences were statistically significant(t=3.44,4.66,P<0.05),but there was no significant difference in CR between the healthy side and the affected side(t=1.31,P>0.05).The AEMG values of thigh rectus femoris and biceps femoris muscle in the stroke group were not statistically different with the left side and right side of the normal group(t=0.15,-2.02,0.34,-3.25,P>0.05).CR in the stroke group was lower than that in the left and right sides of the normal group,and the difference was statistically significant(t=-2.50,-3.27,P<0.05).Conclusion In patients with cerebral apoplexy asymmetry between the healthy side limb muscle contraction,the contralateral limb muscles overcompensation activation,which reveals that the feeling due to stroke the lack of sports information integration and the loss of posture control flexibility.Patients with stroke should strengthen the side of the lower limb muscle activation in order to maintain sit stand position control in the process of balance and avoid to fall.