IEEE Trans Neural Syst Rehabil Eng. 2017 Oct;25(10):1802-1811. doi: 10.1109/TNSRE.2017.2682298. Epub 2017 Mar 15.
We investigated spatial activation patterns of upper extremity muscles during isometric force generation in both intact persons and in hemispheric stroke survivors. We used a 128-channel surface electromyogram (EMG) grid to record the electrical activity of biceps brachii muscles during these contractions. EMG data were processed to develop 2-D root mean square (RMS) maps of muscle activity. Our objective was to determine whether motor impairments following stroke were associated with changes in the muscle activity maps and in the spatial distribution of muscular activation. We found that, for a given subject, spatial patterns in muscle activity maps were consistent across all measured contraction levels differing only the RMS EMG. However, the maps from opposite arms (stroke-affected versus non-affected) of stroke survivors were significantly different from each other, especially when compared with the differences observed intact participants. Our analyses revealed that chronic stroke altered the size and location of the active region in these maps. The former is potentially related to disruption of fiber and tissue structure, possibly linked to factors such as extracellular fat accumulation, connective tissue infiltration, muscle fiber atrophy, fiber shortening, and fiber loss. Changes in spatial patterns in muscle activity maps may also be linked to a shift in the location of the innervation zone or the endplate region of muscles. Furthermore, the textural analysis of EMG activity maps showed a larger pixel-to-pixel variability in stroke-affected muscles. Alterations in the muscle activity maps were also related to functional impairment (estimated using Fugl-Meyer score) and to the degree of spasticity (estimated using the modified Ashworth scale). Overall, our investigation revealed that the muscle architecture and morphology were significantly altered in the chronic stroke.
我们研究了正常人和半球性脑卒中幸存者在等长力产生过程中上肢肌肉的空间激活模式。我们使用 128 通道表面肌电图(EMG)网格记录这些收缩过程中肱二头肌的电活动。对 EMG 数据进行处理,以开发肌肉活动的 2-D 均方根(RMS)图。我们的目的是确定脑卒中后运动障碍是否与肌肉活动图和肌肉激活的空间分布变化有关。我们发现,对于给定的受试者,肌肉活动图中的空间模式在所有测量的收缩水平上都是一致的,仅 RMS EMG 不同。然而,脑卒中幸存者对侧手臂(受影响与未受影响)的图谱彼此明显不同,与完整参与者观察到的差异相比尤其明显。我们的分析表明,慢性脑卒中改变了这些图谱中活跃区域的大小和位置。前者可能与纤维和组织结构的破坏有关,可能与细胞外脂肪积累、结缔组织浸润、肌肉纤维萎缩、纤维缩短和纤维丢失等因素有关。肌肉活动图中空间模式的变化也可能与支配区或肌肉终板区域位置的变化有关。此外,EMG 活动图的纹理分析显示,受影响肌肉的像素间变异性更大。肌肉活动图的改变也与功能障碍(用 Fugl-Meyer 评分估计)和痉挛程度(用改良 Ashworth 量表估计)有关。总体而言,我们的研究表明,慢性脑卒中显著改变了肌肉的结构和形态。