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目的采用肌电积分值(IEMG)对脑卒中偏瘫患者的肘关节屈肌(肱二头肌)痉挛进行量化评定,并建立与改良Ashworth分级相对应的肌电积分值量化区间。方法参照改良Ashworth分级标准将90例受试者进行分组,其中0级20例、Ⅰ级16例、Ⅰ~+级16例、Ⅱ级20例、Ⅲ级18例。记录上述受试者在肘关节持续被动屈伸时肱二头肌表面肌电积分值的变化并进行统计分析。结果受试者各Ashworth分级所对应的肌电积分值范围如下,Ashworth分级为0级对应1.3～12.1(6.7±5.4)μV·s;Ⅰ级对应4.6～12.3(8.5±3.9)μV·s;Ⅰ~+级对应15.3～28.4(21.8±6.6)μV·s;Ⅱ级对应37.2～68.9(53.1±15.6)μV·s;Ⅲ级对应82.3～144.1(113.2±30.9)μV·s。除Ashworth分级为0级与Ⅰ级所对应的IEMG范围有重叠,IEMG均数间差异无统计学意义(P>0.05)外,其它各Ashworth分级所对应的IEMG范围均无重叠,IEMG均数间差异均有统计学意义(P<0.05)。结论肌电积分值可对除Ashworth分级为Ⅰ级以外的脑卒中偏瘫患者肘关节屈肌痉挛进行客观评定及量化分级。
OBJECTIVE: To quantitatively assess spasticity of elbow flexors (biceps brachii) in stroke patients with hemiplegic stroke by using electromyographic integral (IEMG) and to establish quantitative intervals of electromyography integrals corresponding to modified Ashworth classification. Methods According to the modified Ashworth classification, 90 subjects were divided into group 0, 20 grade Ⅰ, 16 grade Ⅰ, 16 grade Ⅰ ~ +, 20 grade Ⅱ, and 18 grade Ⅲ. Record the above subjects in the elbow continued passive flexion and extension of the biceps muscle surface electromyography integral changes and statistical analysis. Results The ranges of Ashweek scores of the subjects were as follows: Ashworth grade 0 corresponds to 1.3 ~ 12.1 (6.7 ± 5.4) μV · s; grade Ⅰ corresponds to 4.6 ~ 12.3 (8.5 ± 3.9) μV · s; The Ⅰ ~ + level corresponds to 15.3 ~ 28.4 (21.8 ± 6.6) μV · s; the Ⅱ level corresponds to 37.2 ~ 68.9 (53.1 ± 15.6) μV · s; and the Ⅲ level corresponds to 82.3 ~ 144.1 (113.2 ± 30.9) μV · s. Except Ashworth grade 0 and grade I IGR overlap, IEMG mean no significant difference (P> 0.05), other Ashworth grade IEMG no overlap, IEMG mean The differences were statistically significant (P <0.05). Conclusion The EMG score can objectively assess and quantify elbow flexor spasm in patients with hemiplegia except Ashworth grade Ⅰ.