痉挛型脑瘫儿童手术后表面肌电信号和关节角度评估

Assessment of Postoperative Surface Electromyography and Joint Angle in Children with Spastic Cerebral Palsy

目的通过表面肌电(surface electromyography,sEMG)和关节角度评估脑瘫儿童手术后运动功能。方法采集16名痉挛型脑瘫患儿手术前后直线行走时股直肌、股二头肌、半腱肌、胫骨前肌、腓肠肌内外侧sEMG和髋、膝、踝关节角度,计算各步态时期sEMG均方根、积分肌电值和关节角度均值,进行肌力肌张力评估。结果手术后,患儿下肢肌肉肌张力均显著降低(P<0.05),股直肌和股二头肌在摆动阶段肌力减小。胫骨前肌在摆动中末期肌力增大(P<0.05)。髋、膝关节屈曲角降低(P<0.05)。踝关节背屈角增大(P<0.05),内翻角减小(P<0.05)。结论治疗后患者蹲伏步态和马蹄内翻足均得到改善,运动功能得到提升。sEMG结合关节角度分析可对患者肌肉功能进行定量评估,为临床诊断提供参考。

Objective To analyze and assess the postoperative motor function in children with spastic cerebral palsy(SCP)by surface electromyography(sEMG)and joint angle.Methods Sixteen children with SCP were involved in this study.The sEMG of rectus femoris,biceps femoris,semitendinosus,tibialis anterior,lateral gastrocnemius and medial gastrocnemius muscles and joint angles of the hip,knee and ankle during straight walking were collected preoperatively and postoperatively.In every gait phase,the mean values of joint angles,root mean square and integrated electromyography of sEMG were calculated,to evaluate muscle strength and muscular tension quantitatively.Results The muscle tension of lower limbs was significantly decreased(P<0.05).The muscle strength of rectus femoris and biceps femoris was decreased in the swing phase.At the midswing and terminal swing phase,the strength of tibialis anterior increased significantly(P<0.05).The flexion angle of hip and knee decreased significantly(P<0.05).The dorsiflexion angle of ankle increased significantly(P<0.05),and the varus angle decreased significantly(P<0.05).Conclusions After operation,the crouching gait and clubfoot were improved positively.Therefore,the motor function of children was improved.Combining sEMG and joint angle can evaluate the muscle function of patients quantitatively,and it also can provide references for clinical diagnosis.