SEMG Assessment Of Wrist And Hand Dysfunction Recovery By Hand Splint Treatment In Post-stroke Patients:A Clinical Study

Objective:Hand splints as a rehabilitation method are widely used in clinic rehabilitation because of their easy operation and low cost.The present study as an independent research,aimed to identify recovery of their wrist and hand function in stroke survivors,using the hand splint developed by us.We evaluated their wrist and hand function recovery by not only the functional scores or scales but also surface electromyography(sEMG)technology.Methods:We rolled 46 post-stroke patients with wrist and hand dysfunction,who were randomly allocated into the experimental group(n=21 at last)and the control group(n=22 at last).All patients in both groups were treated with traditional rehabilitation 5 times a week in all 4 weeks.The participants in the experimental group were worn the hand splints to maintain a functional intervention,and the treatment was conducted no less than 8h a day,7 days a week and totally 4 weeks.Modified Ashworth classification score(MAS),Modified Barthel index scale(MBI),Fugl-Meyer upper limb motor function assessment scale(FMA-UE)were used to assess functional improvement of muscle spasms,daily life ability and upper limb motor function.Desktop DTS type 16 channel sEMG equipment(NORAXON company)with dedicated electromyographic signal processing software(MyoResearch XP Basic edition 3.8.20)was used to record sEMG signals of wrist and hand muscles.Root mean square value(RMS)and the maximum amplitude(MAX)of sEMG were collected for data analysis.SPSS 19.0 statistical software was used to analyses data with the chi-square test and the repeated measurement of variance analysis.The repeated measurement variables with different factors were compared in two groups.On this basis,to further explore the growth trend of rating scale and sEMG values in each group.Results:(1)Comparison in each group,the three repeated measurements of MAS,MBI,FMA-UE scores were shown statistically significant(P<0.001).MAS,MBI and FMA-UE scores compared in both groups were no statistical difference(P>0.05).(2)The three repeated measurements of wrist flexor,wrist extensors,Major-thenar and finger extensors muscles RMS and MAX were statistically significant(P<0.001),while the two group interaction without statistical difference(P>0.05).(3)Experimental group has statistical difference with control group on the improvement of the growth rate of FMA-UE scales and wrist extensors,Major-thenar,finger extensors RMS and MAX(P<0.05).Conclusion:(1)Data analysis showed that the period time of treatment was a significant impact on wrist and hand muscle spasm,daily life activities ability and the upper limb movement function of post-stroke patients.(2)sEMG data showed that splint intervention treatment had no obvious improvement on recovery of wrist flexor motor function.(3)Comparing with traditional rehabilitation treatment,hand splint treatment had no significant improvement on the rating scale and sEMG at the end of 4 weeks treatments.(4)In the early period of rehabilitation intervention,hand splint treatment may play a better role on recovering of abilities of the level of upper limb movement function.Additionally,we also discovered that the hand splint treatment might help on rehabilitation of wrist extensors,Major-thenar and finger extensors muscle strength.