IEEE Trans Neural Syst Rehabil Eng. 2017 Nov;25(11):2105-2112. doi: 10.1109/TNSRE.2017.2707582. Epub 2017 May 24.
The objective of this paperwas to characterize complex neuromuscular changes induced by a hemisphere stroke through a novel clustering index (CI) analysis of surface electromyogram (EMG). The CI analysis was performed using surface EMG signals collected bilaterally from the thenar muscles of 17 subjects with stroke and 12 age-matched healthy controls during their performance of varying levels of isometric muscle contractions. Compared with the neurologically intact or contralateral muscles, mixed CI patterns were observed in the paretic muscles. Two paretic muscles showed significantly increased CI implying dominant neurogenic changes, whereas three paretic muscles had significantly reduced CI indicating dominantmyopathic changes; the other paretic muscles did not demonstrate a significant CI alternation, likely due to a deficit of descending central drive or a combined effect of neuromuscular factors. Such discrimination of paretic muscles was further highlighted using a modified CI method that emphasizes between-side comparison for each individual subject. The CI findings suggest that there appears to be different central and peripheral processes at work in varying degrees after stroke. This paper provides a convenient and quantitative analysis to assess the nature of neuromuscular changes after stroke, without using any special equipment but conventional surface EMG recording. Such assessment is helpful for the development of appropriate rehabilitation strategies for recovery of motor function.
本文旨在通过表面肌电图（sEMG）的新型聚类指数（CI）分析，来描述半球卒中引起的复杂神经肌肉变化。该 CI 分析使用来自 17 名卒中患者和 12 名年龄匹配的健康对照者双侧鱼际肌的 sEMG 信号，在进行不同水平的等长肌肉收缩时进行。与神经完整或对侧肌肉相比，麻痹肌肉中观察到混合 CI 模式。两个麻痹肌肉的 CI 显著增加，表明主要是神经源性变化，而三个麻痹肌肉的 CI 显著降低，表明主要是肌病性变化；其他麻痹肌肉的 CI 没有明显变化，可能是由于下行中枢驱动不足或神经肌肉因素的综合影响。使用强调每个个体的双侧比较的改进 CI 方法，进一步突出了这种麻痹肌肉的区分。CI 发现表明，卒中后似乎存在不同程度的中枢和外周过程。本文提供了一种方便且定量的分析方法，可评估卒中后神经肌肉变化的性质，而无需使用任何特殊设备，只需常规的表面肌电图记录。这种评估有助于制定适当的康复策略，以恢复运动功能。
