基于表面肌电信号和关节角度的痉挛型脑瘫儿童手术后运动功能评估
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1.上海理工大学 医疗器械与食品学院 康复工程与技术研究所;2.上海浦南医院 功能神经外科;3.上海健康医学院 医疗器械学院

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Assessment of postoperative motor function in children with spastic cerebral palsy based on surface electromyography and joint angle
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    摘要:

    目的 通过表面肌电和关节角度评估脑瘫儿童手术后运动功能。方法 采集16名痉挛型脑瘫患儿手术前后直线行走时股直肌、股二头肌、半腱肌、胫骨前肌、腓肠肌内外侧的表面肌电,和髋、膝、踝关节角度,计算各步态时期表面肌电的均方根、积分肌电值和关节角度均值,进行肌力肌张力评估。结果 手术后,患儿下肢肌肉肌张力均显著降低(P<0.05),股直肌和股二头肌在摆动阶段肌力减小。胫骨前肌在摆动中末期肌力增大(P<0.05)。髋关节和膝关节屈曲角降低(P<0.05)。踝关节背屈角增大(P<0.05),内翻角减小(P<0.05)。结论 治疗后患者蹲伏步态和马蹄内翻足均得到改善,运动功能得到提升。表面肌电结合关节角度分析可对患者肌肉功能进行定量评估,为临床诊断提供参考。

    Abstract:

    Objective To analyze and assess the postoperative motor function in children with spastic cerebral palsy (SCP) by surface electromyography (sEMG) and joint angle. Methods Sixteen children with SCP were involved in this study. sEMG of 6 muscles (rectus femoris, biceps femoris, semitendinosus, tibialis anterior, lateral gastrocnemius and medial gastrocnemius) and joint angle of hip, knee and ankle were collected preoperatively and postoperatively. In every gait phase, the mean of joint angle, root mean square and integrated electromyogram of sEMG were calculated, to evaluate muscle strength and muscle tone quantitatively. Results The muscle tension of lower limbs was significantly decreased (P<0.05). The muscle strength of rectus femoris and biceps femoris was decreased in the swing phase. At the midswing and terminal swing phase, the strength of tibialis anterior increased significantly (P<0.05). The flexion angle of hip and knee decreased significantly (P<0.05). The dorsiflexion angle of ankle increased significantly (P<0.05), and the varus angle decreased significantly (P<0.05). Conclusions After operation, the crouching gait and clubfoot were improved positively. Therefore, the motor function of children was improved. Combining sEMG and joint angle can evaluate the muscle function of patients quantitatively, and it also can provide reference for clinical diagnosis.

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  • 收稿日期:2021-09-06
  • 最后修改日期:2021-09-30
  • 录用日期:2021-10-11
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