本文選題：膝關(guān)節(jié)控制障礙　切入點：表面肌電圖　出處：《中華全科醫(yī)學》2016年05期 　論文類型：期刊論文

【摘要】：目的觀察腦卒中后痙攣性偏癱患者在屈伸患者膝關(guān)節(jié)時雙側(cè)大腿各肌群的表面肌電信號特征,為腦卒中痙攣性偏癱患者膝關(guān)節(jié)運動控制障礙的康復訓練提供電生理依據(jù)。方法使用表面肌電圖(surface electromyography,s EMG)檢測正常對照組35例健康人和2013年7月—2014年12月在浙江省臺州醫(yī)院住院的腦卒中后偏癱下肢痙攣狀態(tài)的35例患者股外側(cè)肌、股內(nèi)側(cè)肌、股直肌及股二頭肌的肌電信號變化,觀察在膝關(guān)節(jié)屈曲和伸展狀態(tài)下均方根值(RMS),協(xié)同拮抗率(CR)的變化對患者預后的影響。結(jié)果在膝關(guān)節(jié)伸展狀態(tài)下時,健側(cè)與患側(cè)股外側(cè)肌、股內(nèi)側(cè)肌、股直肌及股二頭肌的RMS值顯著小于正常對照組(P0.01),而健側(cè)與患側(cè)CR顯著大于正常對照組(P0.05),但患側(cè)的RMS值及CR均小于健側(cè)(P0.05)。在膝關(guān)節(jié)屈曲狀態(tài)下時,患側(cè)股外側(cè)肌、股內(nèi)側(cè)肌、股直肌及股二頭肌的RMS值均小于正常對照組及健側(cè)(P0.01);患側(cè)股外側(cè)肌、股內(nèi)側(cè)肌、股直肌及股二頭肌CR大于正常對照組,但差異無統(tǒng)計學意義(P0.05);健側(cè)股內(nèi)側(cè)肌及股二頭肌的RMS值及CR均小于正常對照組,但差異無統(tǒng)計學意義(P0.05)。結(jié)論腦卒中后痙攣性偏癱患者下肢健患側(cè)屈伸肌都存在主動肌與拮抗肌協(xié)調(diào)性的異常,表面肌電圖技術(shù)可以實時定量評價腦卒中后痙攣性偏癱患者膝關(guān)節(jié)控制障礙主動肌與拮抗肌協(xié)調(diào)性,為制定康復方案及預后的評價提供有力的依據(jù)。
[Abstract]:Objective to observe the surface electromyography (EMG) characteristics of the muscles of both thighs in patients with spastic hemiplegia after stroke during knee joint flexion and extension. To provide electrophysiological basis for rehabilitation training of knee joint motor control disorder in stroke patients with spastic hemiplegia methods Surface electromyography (EMG) was used to detect 35 healthy people in normal control group and in Zhejiang Province from July 2013 to December 2014. The lateral femoral muscles of 35 patients with hemiplegia in lower extremity spasm after stroke were hospitalized in Taizhou Hospital. The changes of electromyography (EMG) of medial femoral muscle, rectus femoris muscle and biceps femoris muscle were observed. Contralateral and affected lateral femoral muscles, medial femoral muscles, The RMS value of rectus femoris and biceps femoris was significantly lower than that of the normal control group (P 0.01), while the CR of the healthy side and the affected side was significantly higher than that of the normal control group (P 0.05), but the RMS and CR values of the affected side were lower than those of the contralateral side (P 0.05). When the knee joint flexion, the lateral femoral muscle and the medial femoral muscle of the affected side were significantly lower than those of the control group. The RMS values of rectus femoris and biceps femoris were lower than those of normal control group and control group, while the CR of the affected lateral femoral muscle, medial femoral muscle, rectus femoris muscle and biceps femoris muscle were higher than those of the normal control group. The RMS and CR of medial femoral muscle and biceps femoris of healthy side were lower than those of normal control group. But there was no significant difference in P0.05.Conclusion there is an abnormal coordination between the active and antagonistic muscles in the lower extremity healthy flexor and extensor muscles in patients with spastic hemiplegia after stroke. Surface electromyography can be used to evaluate the coordination of active and antagonistic muscles of knee joint control disorder in patients with spastic hemiplegia after stroke in real time.
【作者單位】： 溫州醫(yī)科大學附屬臺州醫(yī)院康復醫(yī)學科;溫州醫(yī)科大學附屬第二醫(yī)院康復醫(yī)學科;
【基金】：浙江省醫(yī)藥衛(wèi)生科技計劃項目(2014KYA224);浙江省醫(yī)藥衛(wèi)生科技計劃項目(2012KYB238);浙江省醫(yī)藥衛(wèi)生科技計劃項目(2010KYB124) 浙江省臺州市科技計劃項目(14SF03) 浙江省中醫(yī)藥科技計劃項目(2011ZB158)
【分類號】：R743.3

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