脑卒中偏瘫患者双侧上肢肱二三头肌最大等长收缩时的表面肌电分析

目的 通过脑卒中偏瘫患者健、患侧上肢最大等长收缩(MIVC)屈、伸肘时的表面肌电表现,探讨脑卒中偏瘫患者双侧上肢的肘功能状态.方法 选取2017年2月至2018年4月安徽医科大学第二附属医院康复医学科收治的30例脑卒中偏瘫患者为观察组,同期选取30例健康志愿者为对照组.使用表面肌电设备采集观察组双侧上肢及对照组一侧上肢MIVC屈、伸肘时肱二、三头肌的表面肌电信号,提取3 s峰值的均方根值(RMS);计算出协同收缩率(CR).统计分析观察组健侧、患侧上肢与对照组间RMS及CR的差异.结果 ①MIVC屈/伸肘时肱二、三头肌RMS:观察组患侧上肢<健侧上肢<对照组,差异均有统计学意义(P<0.05).②MIVC屈肘CR/伸肘CR:观察组患侧上肢为22.48±8.78/34.38±19.27、观察组健侧上肢为17.53±7.81/18.18±7.98、对照组为12.41±5.06/13.66±3.73.MIVC屈肘C/伸肘CR,观察组患侧上肢>健侧上肢>对照组,差异均有统计学意义(P<0.05).结论 脑卒中偏瘫患者患侧及健侧上肢屈、伸肘功能均明显受损,且患侧上肢屈、伸肘功能受损更为严重.

Analysis of surface myoelectricity of biceps and triceps muscles under MIVC in bilateral arms of hemiplegia patients after stroke

Objective To study the bilateral elbow function of hemiplegia patients after stroke by analyzing their surface myoelectric-ity findings of the affected and healthy lateral upper limbs under maximum isometric voluntary contraction ( MIVC) in the case of elbow flex-ion and extension. Methods 30 cases of hemiplegia patients after stroke ever treated in our hospital between Feb 2017 and Apr 2018 were chosen as the study group, and other 30 healthy voluntary adults were selected as the control group. The surface myoelectricity devices were applied to gather the surface myoelectricity signals of biceps and triceps muscles under MIVC in the bilateral arms of patients in the study group and the lateral arms of volunteers in the control group when flexing and extending their elbows. Then the root mean square ( RMS) of peak value in 3 seconds was extracted, and the co-contraction ratio ( CR) of elbows flexion and extension were also calculated. Differences of RMS and CR among the affected and healthy arms in the study group and the healthy arms in the control group were compared and ana-lyzed. Results In the study group, the RMS values of biceps and triceps muscles under MIVC in the affected arms were significantly lower than those in the healthy arms whether flexing or extending the elbows (P<0. 05), and the RMS values in the healthy arms of study group were also significantly lower than those in the arms of control group (P<0. 05). The CR results under MIVC in the case of elbow flexion and extension were 22. 48 ± 8. 78 and 34. 38 ± 19. 27 in the affected arms of study group (the highest), 17. 53 ± 7. 81 and 18. 18 ± 7. 98 in the healthy arms of study group, and 12.41 ±5.06 and 13.66 ±3.73 in the arms of control group (the lowest), and differences among them were all statistically significant (P<0. 05). Conclusion For those hemiplegia patients after stroke, the elbow function of flexion and ex-tension in the affected and healthy sides are both largely impaired, and impairments in the affected side being more serious.