不同恢复期脑卒中患者胫骨前肌和腓肠肌表面肌电信号的研究  

A comparison study about the surface electromyography on the anterior tibialis and gastrocnemius muscles between the patients of stroke in different stage of recovery

作　　者：郭京伟[1] 谢欲晓[1] 黄学英[2] 宋军[1] 孙启良[1] 

机构地区：[1]中日友好医院康复科,北京100029 [2]山东中医药高等专科学校

出　　处：《中国康复医学杂志》2007年第9期802-804,811,共4页Chinese Journal of Rehabilitation Medicine

摘　　要：目的:探讨脑卒中偏瘫患者恢复期sEMG信号的特点及规律。方法:17例偏瘫患者分为两组,A组9例均为Brunnstrom Ⅳ期的患者,B组8例均为Brunnstrom Ⅴ期的患者,在进行踝关节背屈最大自主收缩的同时,采用表面肌电图仪记录患侧和健侧的胫骨前肌和腓肠肌外侧头收缩的肌电信号,并对两组的积分肌电值、协同收缩率等观测指标进行分析比较。结果:B组患侧胫骨前肌积分肌电值明显高于A组(P<0.01),B组患侧协同收缩率则明显低于A组(P<0.01﹚,而两组的患侧腓肠肌、健侧胫骨前肌、健侧腓肠肌积分肌电,以及健侧的协同收缩率之间差异无显著性(P>0.05);A、B两组的患侧与健侧胫骨前肌积分肌电、患侧与健侧协同收缩率之间均有不同程度的差异(P<0.01或P<0.05﹚,而两组患侧与健侧腓肠肌积分肌电之间差异均无显著性(P>0.05)。结论:恢复后期的偏瘫患者踝背屈主动肌的收缩功能及对拮抗肌协同收缩的控制能力明显好于恢复前期的偏瘫患者。sEMG作为一种简便的、非创伤性的检查方法,在脑卒中偏瘫运动功能评价中具有潜在的临床应用价值。Objective：To explore the feature and regularity of surface electromyography in different stage of recovery of hemiplegic patients after stroke. Method： Seventeen hemiplegic patients were divided into 2 groups： Group A, 9 subjects＇ lower extremity at Brunnstrom motor recovery stage Ⅳ; Group B, 8 subjects, at Brunnstrom recovery stage Ⅴ. The signals of surface electromyography of anterior tibialis and gastrocnemius muscles were recorded during maximum voluntary contraction （MVC） of ankle dorsiflexion. Integrated EMG and co-contraction ratio of both groups were compared and analyzed. Result： There were great significant differences in integrated EMG of anterior tibialis muscles and co-contraction ratio of affected side between two groups （P〈0.01）. However, no significant difference was found in integrated EMG of affected side gastrocnemius muscles, as well as the anterior tibialis and gastrocnemius muscles and co-contraction ratio of the unaffected side between two groups （P〉0.05）. There were significant differences in the integrated EMG of anterior tibialis muscles and co-contraction ratio affected side and unaffected side between both groups（P〈0.01--0.05）. Conclusion： The function of ankle dorsiflexion contraction and the ability of inhibiting antagonist co-contraction in later stage of recovery after stroke were greatly better than earlier stage. As a convenient and untraumatogenic examination technique, surface electromyography has potential value in motor functional assessment for hemiplegic patient after stroke.

关 键 词：脑卒中 恢复期 表面肌电图 踝关节 

分 类 号：R743.3[医药卫生—神经病学与精神病学]