持续等速被动运动对脑卒中患者下肢表面肌电的影响  

Effect of Continuous Passive Motion on the Surface Electromyography of Gastrocnemius Muscle in Stroke Patients

作　　者：李雪萍[1] 程凯[1] 周俊[1] 杨婷[1] 于俊龙[1] 陈安亮[1] 张红飞[1] 王滨[1] 

机构地区：[1]南京医科大学附属南京第一医院康复医学科,南京210006

出　　处：《中国康复》2008年第6期391-393,共3页Chinese Journal of Rehabilitation

摘　　要：目的:研究持续踝关节等速被动运动对脑卒中患者下肢表面肌电及肌痉挛的影响。方法:15例脑卒中患者(观察组)均有瘫痪侧痉挛性足下垂,将观察组患者患侧与15例正常人(对照组)对应侧踝关节进行持续等速被动运动,时间分别为5、10min,角速度为5°/s,于运动前后测定双下肢在直腿坐位、踝关节被动90°时的腓肠肌表面肌电均方根值(RMS)和综合痉挛量表评分(CSS);并进行分析与比较。结果:持续等速被动运动前,观察组运动5、10min时腓肠肌RMS值明显高于对照组(3.0±1.4,3.4±1.8与1.8±0.9,1.7±0.8,P<0.01),运动后均明显低于治疗前(1.8±0.8、1.9±1.0,P<0.01)。观察组运动5、10min时CSS评分与治疗前比较明显下降(12.1±3.3、12.2±2.0与14.5±1.7,P<0.01,0.05)。观察组运动5与10minRMS值及CSS评分均差异无显著性意义。结论:持续等速被动运动能有效缓解脑卒中患者腓肠肌肌痉挛,改善踝关节运动功能,表面肌电可作为评定肌痉挛状况的量化指标,具有临床使用价值。Objective： To observe the change of the surface electromyography （sEMG） on gastrocnemius muscle in stroke patients after continuous passive motion of ankle. Methods： Fifteen stroke patients （observation group） and 15 normal subjects （control group） were involved in this study. All subjects were subjected to continuous passive motion of ankle on the affected sides in observation group and on the corresponding side in control group at the angular velocity of 5°/s for 5 min or 10 min respectively. Before and after the motion, the root mean square （RMS） value of sEMG and composite spasticity scale （CSS） scores in the two groups were compared. Results： Before the continuous passive motion, the RMS values （3.0±1.4, 3.4±1.8） of gastrocnemius muscle in observation group （5 rain or 10 min） were higher than those in control group （1.8±0.9, 1.7±0.8） （P〈0.01）. In observation group, the RMS values （1.8±0.8, 1.9±1.0） of gastrocnemius muscle and CSS scores （12.1±3.3, 12.2±12.0） after the continuous passive motion were lower than before （CSS scores 14.5± 1.7, P〈0.01, P〈0.05）. There was no significant difference in the RMS values and CSS scores between the 5 rain and 10 min movement in observation group. Conclusion： Continuous passive motion is an effective therapy for patients with gastro chemius muscle spasticity after stroke. SEMG can quantitatively estimate muscle spastcity.

关 键 词：等速运动 表面肌电 脑卒中 踝关节 肌痉挛 

分 类 号：R87[医药卫生—运动医学] R743.3[医药卫生—临床医学]