基于表面肌电图检查技术的脑卒中患者下肢肌肉痉挛的定量分析  

A quantitative analysis of lower limb muscle spasticity in stroke survivors

作　　者：廖志平[1] 马利娜[1] 李建华[1] 何武丹 

机构地区：[1]浙江大学医学院附属邵逸夫医院康复医学科,杭州310053 [2]余姚市康复医院康复科

出　　处：《中华物理医学与康复杂志》2017年第5期347-350,共4页Chinese Journal of Physical Medicine and Rehabilitation

摘　　要：目的探讨脑卒中偏瘫患者股四头肌表面肌电图（sEMG）信号和改良Ashworth分级（MAS）之间的相关性，研究表面肌电图指标是否可作为评估痉挛的量化指标。方法选择符合标准的脑卒中患者60例，由同一测试人员对脑卒中偏瘫患者患侧股四头肌进行MAS评估，并记录股四头肌被动牵伸时股四头肌内侧头（VM）、股直肌（RF）、股四头肌外侧头（VL）处表面肌电信号的均方根值（RMS）值和平均肌电值（AEMG）值，对不同表面肌电图指标与MAS进行相关性分析。结果被动牵伸股四头肌时，VM、RF、VL的表面肌电信号都与MAS分级呈正相关；经Spearman相关统计分析，被动活动时，VM（r=0．751）、VL（r=0．563）、RF（r=0．800）的均方根值（RMS）均与MAS相关（P〈0．001）；VM（r=0．767）、VL（r=0．646）、RF（r=0．834）的平均肌电值（AEMG）均与MAS相关（P〈0．001）。结论脑卒中偏瘫患者被动牵伸股四头肌（VM、VL、RF）时，表面肌电信号的RMS指标及AEMG指标与MAS分级呈正相关；sEMG检查股四头肌被动牵伸时的幅度指标可为临床肌张力评估和痉挛的治疗提供量化的参考。Objective To relate the results of surface electromyography （sEMG） of the femoris among patients with hemiplegia after a brain lesion with scores on the modified Ashworth scale （MAS）, and to decide whether sEMG can be used as a quantitative index for evaluating spasm. Methods The affected quadriceps femoris of sixty hemiplegic stroke survivors were assessed by the same therapist using the MAS. sEMGs were also recorded and the root mean square and average sEMG readings from the vastus medialis （VM）, rectus femoris （RF） and vastus lateralis （VL） were extracted. The correlation between these sEMG indexes and the MAS grading was analyzed. Results The average sEMG signals from the VM, RF and VL were strongly correlated with the MAS grading, and they increased with increasing MAS grade. Spearman correlation analysis demonstrated highly significant correlation （P〈 0.001） when the quadriceps femoris was moved passively. Conclusions Surface EMG signals from the VM, RF and VL correlate well with MAS grades, rising when the affected quadriceps femoris of a stroke survivor is moved passively, sEMG can present the electrical activity during passive movements of the quadriceps femoris and can be useful in spasticity assessment and clinical treatment.

关 键 词：脑卒中 表面肌电同 痉挛 股四头肌 

分 类 号：R743.3[医药卫生—神经病学与精神病学]