脑卒中偏瘫患者康复治疗中肌电F波的变化与运动障碍的关系

摘要

To investigate the correlation between the changes of electromyographic F-wave and dyskinesia in stroke patients with hemiplegia during rehabilitation therapy.Methods 44 cases of stroke patients with hemiplegia during rehabilitation therapy (stroke group)and 44 cases of healthy examiners (con-trol group)in our hospital from November 2016 to November 2018 were selected.After admission,patients were given routine symptomatic treatment and rehabilitation treatment.F wave was detected by Kepoint.net electromyography/evoked potential instrument.F-wave amplitude and threshold of hemiplegic side,non-para-lytic side in the stroke group were compared with control group.All stroke patients were assessed by the Mo-tor Assessment Scale (MAS),and its correlation with the F wave parameters (F wave amplitude,F wave threshold)was analyzed.Results For 1～ 7 days after onset,there were statistic differences in F-wave ampli-tude and threshold of hemiplegic side and non-paralytic side of stroke group (P0.05), and the F-wave amplitude and threshold of hemiplegic side of stroke group were no difference with those of the non-paralytic side (P>0.05).For 2 1～ 35 days after onset,F-wave amplitude and threshold of hemiplegic side and non-paralytic side of stroke group were no difference with those of the control group (P>0.05),and the F-wave amplitude and threshold of hemiplegic side of stroke group were no difference with those of the non-paralytic side (P>0.05 ).F wave parameters were positively correlated with MAS score (r=0.91 1 , 0.920,0.690,0.671 ,P0.05),脑卒中患者偏瘫侧 F波波幅及阈值与未瘫痪侧比较无统计学差异(P>0.05);发病 21～35 d脑卒中组偏瘫侧、未瘫痪侧F波波幅及阈值与对照组比较无统计学差异(P>0.05),脑卒中患者偏瘫侧 F波波幅及阈值与未瘫痪侧比较无统计学差异(P>0.05 );F 波参数与腕部及四指 MAS 均呈正相关(r=0.9 1 1 ,0.920,0.690,0.671 ,P<0.05).结论 肌电 F波是 1 个在脑卒中偏瘫患者康复治疗中极敏感的神经电生理指标,与运动障碍有一定的相关性,可作为评价运动神经元兴奋性的一种手段.