Chira-Adisai W, Yan K, Shahani B T
Department of Rehabilitation Medicine, Ramathibodi Hospital, Bangkok, Thailand.
Electromyogr Clin Neurophysiol. 2001 Mar;41(2):79-86.
This study attempted to determine changes in motor unit discharge patterns, characterized by serial correlation coefficients (SCC) and fractional parameters during a functional recovery in stroke patients. Using the surface electrode technique, 171 single motor units were recorded from bilateral upper extremities of 23 stroke patients and 7 normal volunteers. SCCs and fractional parameters were calculated and correlated with Rasch-converted Functional Independence Measurement (FIM) scores by linear regression analysis. No statistically significant correlation was found between FIM scores and SCCs and between FIM scores and fractional parameters recorded during first four weeks post stroke. Only FIM for total motor scores and FIM for locomotion subscore significantly correlated with SCC recorded after 4 weeks post stroke (p < 0.05). Predictive power (R2) of SCC for FIM scores did not change much over time. Fractional parameters, recorded after 4 weeks post stroke, had significant correlation with FIM for total motor scores and all FIM subscores except FIM for sphincter control subscores. Predictive values of fractional parameters for FIM scores was better after 6 months post stroke. There was a better correlation between fractional parameters with FIM scores and a better predictive value of fractional parameters for FIM scores over functional recovery period. This change in the correlation during the course of stroke recovery may indicate that fractional parameters could reflect a more stabilized motor control stage rather than a less stabilized motor functional stage.
本研究试图确定中风患者功能恢复过程中以序列相关系数(SCC)和分数参数为特征的运动单位放电模式的变化。采用表面电极技术,从23例中风患者和7名正常志愿者的双侧上肢记录了171个单运动单位。计算SCC和分数参数,并通过线性回归分析将其与Rasch转换后的功能独立性测量(FIM)评分相关联。在中风后的前四周内,未发现FIM评分与SCC以及FIM评分与分数参数之间存在统计学显著相关性。仅中风后4周记录的FIM总运动评分和FIM运动亚评分与SCC显著相关(p < 0.05)。SCC对FIM评分的预测能力(R2)随时间变化不大。中风后4周记录的分数参数与FIM总运动评分以及除FIM括约肌控制亚评分外的所有FIM亚评分显著相关。中风后6个月,分数参数对FIM评分的预测值更好。在功能恢复期间,分数参数与FIM评分之间的相关性更好,分数参数对FIM评分的预测值也更好。中风恢复过程中这种相关性的变化可能表明分数参数可以反映一个更稳定的运动控制阶段,而不是一个不太稳定的运动功能阶段。