Spasticity Evaluation of Hemiparetic Limbs in Stroke Patients before Intervention by Using Portable Stretching Device and EMG

臨床上對於痙攣的評估缺乏量化的工具，而在療效評估上欠缺客觀之量化數據。本研究的目的在於利用可攜式肌肉張力評估系統結合表面肌電圖，對於中風患者上肢在接受治療前痙攣情形進行記錄。本部分在以量化的方式建立治療介入前受試者肌肉張力的情形。在施打肉毒桿菌前兩週，對病人做追蹤評估。將在一定的活動範圍內（六十度）以不同的速度（1/3, 1/2, 1 and 1.5赫茲）牽張肘關節，並同時記錄肱二頭肌及肱三頭肌的肌電訊號及反應力矩。以肌電訊號大於休止肌電訊號的兩倍標準差定義為肌肉活動的閾止，合併由肘關節力矩推算出來的肘屈肌與速度相依之黏性元素(Bω)，作為評估痙攣肌肉張力的參數；這些生物力學及神經生裡的訊號參數也將作為量化評估療效的項目。在目前的研究我們發現，肌肉的黏性元素及被反射激發的肌電訊號皆可以用來量化痙攣的程度。隨著痙攣的嚴重程度不同，黏性及肌電訊號閾止値將向兩個不同的方向變化。這些參數可以較為有效精準的對於中風病人接受肉毒桿菌施打後療效的量化評估。

關鍵字

痙攣；肌肉張力評估系統；肌電圖；肘關節

並列摘要

The aim of this study is to utilize the portable muscle tone measurement device and surface EMG for investigating the spasticity on the elbow flexors before BOTOX(superscript ®) intervention. The reactive torque and reactive EMG (biceps brachii and triceps brachii muscles) of elbow joint induced at different stretching velocities (1/3, 1/2, 1 and 1.5Hz) in limited range (-30 to+30 degrees, 90 degrees of elbow flexion was defined as zero degree) were recorded simultaneously in 2 weeks before BOTOX(superscript ®) treatment. The velocity-dependent viscous component (Bω) of elbow flexor and the EMG threshold defined as the angle at which the sustained EMG activity surpassed two folds of standard deviation of rest EMG prior to stretch were used for evaluating the severity of spasticity. In current study, we demonstrated that the viscoelastic parameter as well as EMG threshold could be used for quantifying the degree of spasticity. These parameters would be useful for quantifying the effects of BOTOX treatment in stroke patients.

並列關鍵字

Spasticity ； Muscle tone measurement system ； EMG ； Elbow

國際替代計量

Spasticity Evaluation of Hemiparetic Limbs in Stroke Patients before Intervention by Using Portable Stretching Device and EMG

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