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頁籤選單縮合
題名 | 中風病人肌肉痙攣狀態之肌電評量 |
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作者 | 鄭玉慧; 詹瑞棋; 江寧; 徐道昌; | 書刊名 | 復健醫學會雜誌 |
卷期 | 22:2 1994.12[民83.12] |
頁次 | 頁91-98 |
分類號 | 415.922 |
關鍵詞 | 痙攣; 偏癱; 肌電圖; Spasticity; Hemiplegia; EMG; |
語文 | 中文(Chinese) |
中文摘要 | 臨床上對於因各種原因引起的痙攣迄今尚無理想的分級以描述其程度,目前較常被應用的方法如Ashworth分級則屬於主觀及粗略的評量。本研究希望能針對臨床需要對於中風之後所產生的肌肉痙攣發展出較為客觀,定量並且精細的測試方法。初步研究收集20位中風之後有半邊肢體痙攣性偏癱的病人,其Brunnstrom stage皆在2-4之間,Ashworth分級亦為2至4級間。以兩側肢體之肱二頭肌及股四頭肌為測試部位,分別進行:1.靜止狀態肌肉活動2.主動維持抗地心引力收縮3.最大肌肉收縮以及4.肌腱反射測試。每個步驟都使用Viking Iie肌電圖儀以表面電極記錄該動作時肌肉所產生的電位變化包括尖端振幅值,平均整流後電位值,平均平方後根號肌電圖值以及轉折數等參數。健側及患側之肌電訊號值以配對t-試驗作統計分析。結果發現1.即使在靜止狀態,患側仍然比健側有更多的肌電活動。2.主動收縮時,健側肌肉均能發出較多之上述肌電波參數。3.敲擊肌腱所誘發出的電位活動在患側明顯大於健側。各個步驟的各項參數值之差異除少數狀況的轉折數(turns)之外都有統計學上的明顯差異性(p<0.05)。由本研究的結果可以知道肌電評量的方法確實能定量顯示肌肉在痙攣狀態下的異常活動性,而且其操作簡單,對病人身體也不具破壞性,很值得再進一步研究及推展。 |
英文摘要 | Clinically, there is still no ideal measurement to grade the spasticity caused by varying causes. The method mostly used such as Ashworth scale is for subjective and gross evaluation. The purpose of this study is to develop a more objective and quantitative test for muscle spasticity in stroke patients. The study recruits 20 cases of stroke patients with spastic hemiplegia whose Brunnstrom stage is graded at 2 to 4, the Ashworth grading is also at 2 to 4. The muscles tested are bilateral biceps brachialis and quadriceps femoris muscles. The following items are proceeded: 1. Muscle activity while in rest. 2. Activity maintained during antigravity contraction. 3.Deep tendon reflex. The surface electrode is applied to record myoelectric activity which include peak to peak amplitude, rectified voltage, root mean square EMG and turns. A pair-t test is used to analyze the myoelectric signals of normal and lesion side. The following are the results: 1.There are more myoelectric activities in the lesion side during resting state. 2.There are more myoelectric signals in normal side muscle during active contraction. 3.The myoelectric activity induced by tendon reflex is significantly larger over lesion side. The differences among varying parameters of each procedure are statistically significant (p<0.05). These findings suggest that the electrophysiologic evaluation can quantify the abnormal activity of spastic muscle. The method is simple and noninvasive, therefore, it worths being further studied and developed. |
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