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评估选择性股神经切断术治疗脑瘫僵直膝的表面肌电图临床分析。

Assessment of surface electromyographic clinical analysis of selective femoral neurotomy on cerebral palsy with stiff knee.

机构信息

Department of Neurosurgery, Yuquan Hospital, Tsinghua University, Beijing 100049, China.

出版信息

J Neurosci Methods. 2011 Jul 15;199(1):98-102. doi: 10.1016/j.jneumeth.2011.04.031. Epub 2011 Apr 30.

DOI:10.1016/j.jneumeth.2011.04.031
PMID:21554900
Abstract

This study aimed to explore the role of surface electromyography (sEMG) on the changes of myoelectric activities of quadriceps femoris and the assessment of its clinical effect before and after selective femoral neurotomy on spastic cerebral palsy with stiff knee. Selective femoral neurotomy was carried out in 15 patients on 26 sides. The electromyography of quadriceps femoris was recorded before and after the operation. Passive and voluntary movements were performed during recording. The root mean square (RMS) and integrated electromyography (iEMG) was calculated by time domain analysis. Meanwhile, the range of the patients' knee joint motion (ROM) was measured by a joint goniometer. The RMS and iEMG of the quadriceps femoris during passive movement was significantly decreased post-operation when compared to those pre-operation (both P<0.05, n=26). Meanwhile, the RMS and iEMG of the quadriceps femoris during voluntary movement post-operation was significantly reduced than those pre-operation (both P<0.05, n=26). Additionally, total excursion on the sagittal plane and the peak knee flexion in the swing phase were significantly raised post-operation than those pre-operation (both P<0.05, n=26). The spasms in the quadriceps femoris in spastic cerebral palsy patients with stiff knee was clearly improved, and the ROM of the knee was significantly enhanced after the selective femoral neurotomy. Importantly, surface EMG can objectively evaluate the clinical therapeutic effect of spastic cerebral palsy stiff knee as a noninvasive detection method.

摘要

本研究旨在探讨表面肌电图(sEMG)在选择性股神经切断术治疗僵硬性脑瘫膝关节痉挛前后股四头肌肌电活动变化中的作用及其临床疗效评估。对 15 例 26 侧患者进行选择性股神经切断术。记录手术前后股四头肌肌电图,记录时进行被动和主动运动。采用时域分析计算均方根值(RMS)和积分肌电图(iEMG),同时采用关节角度计测量患者膝关节活动范围(ROM)。与术前相比,术后被动运动时股四头肌的 RMS 和 iEMG 明显降低(均 P<0.05,n=26)。此外,术后主动运动时股四头肌的 RMS 和 iEMG 明显低于术前(均 P<0.05,n=26)。术后矢状面总活动度和摆动相峰值屈膝明显高于术前(均 P<0.05,n=26)。结论:选择性股神经切断术可明显改善僵硬性脑瘫患者股四头肌痉挛,显著提高膝关节 ROM。重要的是,表面肌电图作为一种无创检测方法,可客观评估僵硬性脑瘫膝关节痉挛的临床治疗效果。

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