脑卒中后痉挛性偏瘫患者膝关节控制能力障碍的sEMG特征研究

发布时间：2018-03-06 16:04

本文选题：膝关节控制障碍　切入点：表面肌电图　出处：《中华全科医学》2016年05期 　论文类型：期刊论文

【摘要】：目的观察脑卒中后痉挛性偏瘫患者在屈伸患者膝关节时双侧大腿各肌群的表面肌电信号特征,为脑卒中痉挛性偏瘫患者膝关节运动控制障碍的康复训练提供电生理依据。方法使用表面肌电图(surface electromyography,s EMG)检测正常对照组35例健康人和2013年7月—2014年12月在浙江省台州医院住院的脑卒中后偏瘫下肢痉挛状态的35例患者股外侧肌、股内侧肌、股直肌及股二头肌的肌电信号变化,观察在膝关节屈曲和伸展状态下均方根值(RMS),协同拮抗率(CR)的变化对患者预后的影响。结果在膝关节伸展状态下时,健侧与患侧股外侧肌、股内侧肌、股直肌及股二头肌的RMS值显著小于正常对照组(P0.01),而健侧与患侧CR显著大于正常对照组(P0.05),但患侧的RMS值及CR均小于健侧(P0.05)。在膝关节屈曲状态下时,患侧股外侧肌、股内侧肌、股直肌及股二头肌的RMS值均小于正常对照组及健侧(P0.01);患侧股外侧肌、股内侧肌、股直肌及股二头肌CR大于正常对照组,但差异无统计学意义(P0.05);健侧股内侧肌及股二头肌的RMS值及CR均小于正常对照组,但差异无统计学意义(P0.05)。结论脑卒中后痉挛性偏瘫患者下肢健患侧屈伸肌都存在主动肌与拮抗肌协调性的异常,表面肌电图技术可以实时定量评价脑卒中后痉挛性偏瘫患者膝关节控制障碍主动肌与拮抗肌协调性,为制定康复方案及预后的评价提供有力的依据。
[Abstract]:Objective to observe the surface electromyography (EMG) characteristics of the muscles of both thighs in patients with spastic hemiplegia after stroke during knee joint flexion and extension. To provide electrophysiological basis for rehabilitation training of knee joint motor control disorder in stroke patients with spastic hemiplegia methods Surface electromyography (EMG) was used to detect 35 healthy people in normal control group and in Zhejiang Province from July 2013 to December 2014. The lateral femoral muscles of 35 patients with hemiplegia in lower extremity spasm after stroke were hospitalized in Taizhou Hospital. The changes of electromyography (EMG) of medial femoral muscle, rectus femoris muscle and biceps femoris muscle were observed. Contralateral and affected lateral femoral muscles, medial femoral muscles, The RMS value of rectus femoris and biceps femoris was significantly lower than that of the normal control group (P 0.01), while the CR of the healthy side and the affected side was significantly higher than that of the normal control group (P 0.05), but the RMS and CR values of the affected side were lower than those of the contralateral side (P 0.05). When the knee joint flexion, the lateral femoral muscle and the medial femoral muscle of the affected side were significantly lower than those of the control group. The RMS values of rectus femoris and biceps femoris were lower than those of normal control group and control group, while the CR of the affected lateral femoral muscle, medial femoral muscle, rectus femoris muscle and biceps femoris muscle were higher than those of the normal control group. The RMS and CR of medial femoral muscle and biceps femoris of healthy side were lower than those of normal control group. But there was no significant difference in P0.05.Conclusion there is an abnormal coordination between the active and antagonistic muscles in the lower extremity healthy flexor and extensor muscles in patients with spastic hemiplegia after stroke. Surface electromyography can be used to evaluate the coordination of active and antagonistic muscles of knee joint control disorder in patients with spastic hemiplegia after stroke in real time.
【作者单位】：温州医科大学附属台州医院康复医学科;温州医科大学附属第二医院康复医学科;
【基金】：浙江省医药卫生科技计划项目(2014KYA224);浙江省医药卫生科技计划项目(2012KYB238);浙江省医药卫生科技计划项目(2010KYB124) 浙江省台州市科技计划项目(14SF03) 浙江省中医药科技计划项目(2011ZB158)
【分类号】：R743.3

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