Analysis Of Surface Electromyographic Characteristics Of Triceps Surae Spasticity In Stroke Patients Treated With Extracorporeal Shock Wave

ObjectiveTo analyses the changes of surface electromyographic characteristics of triceps surae spasticity in stroke patients treated with extracorporeal shock wave and its treat efficacy.ESWT is a new,non-invasive and economical method for the treatment of high limb muscle tone in patients with stroke,which has not been widely applied in clinic.However,the optimal therapeutic parameters of ESWT have not been determined.This study proposed to evaluate the clinical efficacy of ESWT by clinical scale,and use surface electromyography（sEMG）to record the characteristics of muscle tension.Then,the sEMG signal characteristics were analyzed to provide a quantitative reference for adjusting ESWT scheme that was used for relieving spasticity of patients after stroke.MethodA total of 60 patients were enrolled in our study,and were randomly divided into two groups named control group（n=30）and trail group（n=30）.All patients of the two group would accept identical comprehensive rehabilitation therapy.Except these basic treatments,the control group would be given placebo treatment,and the trial group would be given ESWT treatment.The treatment would be conducted three times regularly with an interval of a week.We evaluated the Modified Ashworth Scale（MAS）and the Fugl-Meyer Assessment（FMA）of the lower limbs,and also collected the surface electromyography of the medial head of gastrocnemius muscle,tibialis anterior muscle during the maximum isometric voluntary contraction（MIVC）of ankle dorsiflexion in hemiplegic side.Additionally,we would also analyze the integrated electromyography（iEMG）and co-contraction ratio（CR）.All these analyses and collection would be conducted in both control group and trial group,before the first treatment（t0）,immediately after the first treatment（t1）,immediately after the second treatment（t2）and immediately after the third treatment（t3）respectively.ResultsA total of 60 patients were enrolled in our study,and were randomly divided into two groups named control group（n=30）and trail group（n=30）.There was no statistical difference between the two groups in age,gender,weight,height,course of disease,types of stroke,lesion site and other general information.In control group,there were no statistically significant difference in the parameters including the MAS,FMA,iEMG and CR results when comparing them among t0,t1,t2,and t3,with the P values<0.05.In the contrary,these results showed essential difference in ESWT group,decreasing significantly,with the P values<0.05.Furthermore,the significant differences were also found when comparing these parameters in both control group and trail group at the same therapy time,with the P values<0.05.For the FMA,the t2 and t3 result exhibited significant decease when comparing to to in trial group,with the P values<0.05.However,only t3 results make essential sense,when comparing the FMA between control group and trial group,with the P values<0.05.Conclusion1.ESWT can immediately relieve triceps surae spasticity of hemiplegic side in stroke patients,and reduce iEMG and synergic activation level of gastrocnemius muscle during ankle dorsiflexion.2.Repeated ESWT has more significant therapeutic effect,and can promote the recovery of lower limb motor function in hemiplegic side.3.sEMG can be used to quantitatively evaluate the improvement of spasticity and the level of co-contraction of antagonistic muscle and agonist during ankle dorsiflexion of triceps surae spasticity in stroke patients treated with ESWT.