脑卒中患者痉挛上肢各关节最大等长收缩时的表面肌电信号变化的研究

Changes of sEMG signal during maximal isometric contraction of upper limb joints in patients with stroke

目的探讨脑卒中患者痉挛上肢各关节最大等长收缩(maximum isometric voluntary contraction,MIVC)时表面肌电信号(surface-electromyography,sEMG)特征的变化情况。方法选取本院2017年1月至2019年1月收治的20例脑卒中偏瘫患者作为观察组,并选取同期20名健康体检者作为对照组,比较两组上肢各部位在进行屈腕、屈伸肘及肩外展最大等长收缩时的sEMG信号、收缩率(CR)和共激活比值。结果观察组伸屈肘CR差值明显高于对照组,差异有统计学意义(P<0.05);观察组屈腕时BB、TB、D,屈肘时FCU、BB、D,伸肘时FCU、TB、D及肩外展时BB的共激活比值均高于对照组,差异有统计学意义(P<0.05)。结论脑卒中患者痉挛上肢多以屈肌痉挛模式为主,建议在康复治疗期间应重视抑制屈肌痉挛,以改善上肢肌肉的功能。

Objective To investigate the changes of sEMG signal during the maximal isometric contraction(MIVC)of upper limb joints in patients with stroke.Methods 20 stroke patients with hemiplegia admitted to our hospital from January 2017 to January 2019 were selected as the observation group,and 20 healthy people were selected as the control group at the same time.The sEMG signal,shrinkage rate(CR)and co-activation ratio were compared between the two groups during maximum isometric contraction of flexion wrist,flexion elbow and shoulder abduction.Results The CR difference in the observation group was significantly higher than that in the control group,and the difference was statistically significant(P<0.05).The coactivation ratio of BB,TB and D during wrist flexion,FCU,BB and D during elbow flexion,FCU,TB and D during elbow extension and BB during shoulder abduction in the observation group were all higher than those in the control group,and the difference was statistically significant(P<0.05).Conclusion The main mode of spasm of upper limb in stroke patients is flexor spasm.It is suggested that attention should be paid to the inhibition of flexor spasm and the improvement of the functional recovery of upper limb muscles during rehabilitation.