基于表面肌电信号的腕手功能评定与重建研究  

Rehabilitation assessment and reconstruction of wrist and hand function by surface electromyography

作　　者：王东岩[1] 王伟[2] 周围[2] 郇靖[2] 张然[2] 

机构地区：[1]黑龙江中医药大学附属第二医院康复医学科,哈尔滨150001 [2]黑龙江中医药大学

出　　处：《中国临床保健杂志》2009年第2期131-133,共3页Chinese Journal of Clinical Healthcare

基　　金：黑龙江省中医药;中西医结合科研项目(2006ZHYYR12);哈尔滨市青年科学基金(2004AFQXJ017)

摘　　要：目的通过表面肌电信号特征的提取和分析,建立基于表面肌电信号的脑卒中患者腕手运动功能评定新方法;并以此为基础,通过客观评价中枢神经损伤后上肢及腕手的运动功能,开展不同方案低频电刺激方法促进瘫痪腕手运动重建的疗效评价和相关研究。方法选择Fugl-Meyer上肢腕手评分≥7分的脑梗死、脑出血患者36例,随机分为3组。治疗组A(常规康复+低频电刺激伸肌),治疗组B(常规康复+低频电刺激屈伸肌)和对照组(常规康复),采集患者上肢肘和手腕部活动时主动肌、协同肌、拮抗肌的表面肌电信号(sEMG),提取特征值最大振幅(MAX)、所得肌电信号经整流滤波后单位时间内曲线下面积的总和(AE-MG)。结果治疗后两组患者的腕手功能均有恢复;对照组总有效率为52.47%但治疗组手腕部MAX、AE-MG、Fugl-Meyer运动功能分值、ADL值提高较明显(P<0.05),且治疗组B的疗效(总有效率72.54%)大于治疗组A(总有效率60.76%)。结论sEMG信号检测是一种客观、灵敏且精确的运动评定方法,低频电刺激对脑卒中患者恢复肢体运动功能具有一定促进作用。Objectives To evaluate rehabilitation programs involving low-frequency electrical stimulation （LFS） in order to restore wrist and upper hand function in post-stroke patients with carpal tunnel syndrome by surface electromyography （EMG）, and to apply the new method in our Movement Evaluation and Research program. Methods Thirty-six patients with cerebral hemorrhage （selected on the basis of a score 〉 7 on the Fugl-Meyer scale）were randomly divided into three groups. Group A （LFS of extensor arm muscles and conventional rehabilitation） ,group B （ LFS of extensor and flexor arm muscles and conventional rehabilitation） and the control group（ and conventional rehabilitation）. The following parameters were determined by surface EMG using Eigen-value extraction： Fugl-Meyer motor function score, and wrist MAX, AEMG and ADL. Results In the control group, the total effective rate of hand function was 52.47% , and MAX, AEMG, Fugl-Meyer motor function scale, ADL value were increased in group A and group B. In group A ,total effective rate was higher （60.76%） ,but still significantly lower than that in group B （ total effective rate： 72.54% ）. Conclusion Surface EMG is a more sensitive and accurate method to assess arm movements. Combining with low-frequency electrical stimulation, it could help the stroke patients to recover, and improved medical clinic and rehabilitation of wrist and hand function.

关 键 词：脑血管意外 经皮神经电刺激 手 肌电描述术 评价研究 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R337.5[医药卫生—临床医学]