脑卒中恢复期患者偏瘫上肢治疗后肌电F波变化

摘要

目的 探究脑卒中恢复期患者偏瘫上肢在康复治疗过程中正中神经F波参数变化规律.方法 选择脑卒中偏瘫患者30例,所有患者接受为期4周的常规康复治疗,分别于治疗前及治疗4周后对其上肢正中神经行F波参数检测,同时采用改良Ashworth量表评定患侧上肢的痉挛程度,采用上肢Fugl-Meyer量表评估偏瘫侧上肢运动功能.结果 治疗前患侧上肢的F波波幅、出现率均低于健侧肢体和正常组,阈值高于健侧及正常组,差异有统计学意义(P<0.05).治疗后患侧肢体F波波幅、出现率均较治疗前明显上升,阈值下降,差异有统计学意义(P<0.05).改良Ashworth评分和F波波幅、出现率、阈值等参数有相关性(P<0.05).结论 改良Ashworth评分和F波参数存在相关性,两者可结合用于临床上肢功能障碍的评估.%Objective To study the law of alteration of F-wave parameters in the affected side of stroke conavlescent patients with unilateral hemiplegia after rehabilitation.Methods Thirty stroke patients with hemiplegia of a upper limb were chosen.All received four weeks of conventional rehabilitation.F-wave parameters were recorded in the median nerve before and four weeks after the rehabilitation.Muscle tone of hemiplegic upper limb was assessed using the modified Ashworth scale and motor function was assessed using Fugl-Meyer assessment before and four weeks after the rehabilitation.Results F-wave amplitude,persistence of the affected upper extremitiy were lower than that of contralateral limb and normal control group and F-wave threshold were higher than that of contralateral limb and normal control group,the difference was statistically significant(P<0.05).After treatment,F-wave amplitude,persistence of the affected upper extremitiy was increased and F-wave threshold was decreased when compared with the same parameters before rehabilitation,the difference was statistically significant(P<0.05).The modified Ashworth score and F-wave amplitude,persistence and threshold were correlated(P<0.05).Conclusion There is correlation between modified Ashworth score and F-wave parameters,and F-wave combined with modified Ashworth score can be used for clinical evaluation of upper limb dysfunction.