Effects Of Hemiplegic Side Finger Sensory Stimulation On Functional Recovery And F Wave In Stroke Patients

Objective:Hand dysfunction seriously affects the quality of life of stroke patients.At present,there is still a lack of better rehabilitation methods to improve hand dysfunction in patients with moderate and severe stroke.After stroke,flexor spasm and extensor muscle weakness of hand on hemiplegic side are important adverse factors affecting the recovery of hand function.Our study found that Stimulation of Mechanical Digitorum Sensory Stimulation(MDSS)on the hemiplegic side of stroke patients significantly alleviated digitorum sensory stimulation and promoted active extension of the five fingers.No studies on MDSS were reported except our study.Therefore,it is necessary to further study its exact efficacy and mechanism.For accurate implementation of MDSS,our research group developed Digit sensory stimulator(DSS),which is equipped with pressure display and can display stimulus intensity in real time.As a special examination in electromyography,F-wave can reflect the excitability of α motor neurons in the anterior horn of the spinal cord and the conductivity of motor nerve fibers,and can be used for the objective assessment of muscle tone.The purpose of this study was to investigate the short-term efficacy of MDSS treatment on hemiplegic side hand muscle spasm,muscle strength,upper limb motor function and patients’ daily living ability in stroke patients and its effect on median nerve F-wave.Methods : Fifty convalescent stroke patients who met the natreotype criteria were randomly divided into two groups: conventional rehabilitation group and MDSS group.The conventional rehabilitation group only received conventional rehabilitation treatment,while the MDSS group received conventional rehabilitation combined with MDSS treatment.The modified ashworth scale(MAS)was used to evaluate the tension and manual muscle strength of the hemiplegic side of the hand before treatment and after one course of treatment(12-14 days),respectively.MMT)evaluated muscle strength and Fugl-Meyer Motor Function Scale(Extremity,Fugl-Meyer Assessing-Upper extremity,FMA-UE)to evaluate motor function of hemiplegic upper limbs,Modified Barthel Index(MBI)to evaluate activities of daily living.In addition,bilateral median nerve F wave was detected before treatment in all patients,and the median nerve F wave was detected on the hemiplegic side after one course of treatment.Results:Compared with before treatment,MAS score,upper limb FMA score and MBI index of thumb flexor and middle finger flexor on hemiplegic side,median nerve F-wave parameters(mean latency,amplitude and F/M amplitude ratio)on hemiplegic side were significantly improved in MDSS group and conventional rehabilitation group after treatment(all P<0.05).Except that MMT scores of middle finger flexor muscle in conventional rehabilitation group were decreased(P>0.05),MMT scores of other measured muscle groups in conventional rehabilitation group and all measured muscle groups in MDSS group were increased,but there was no statistical significance(all P>0.05).After treatment,MAS score of thumb flexor muscle and F wave amplitude of median nerve on hemiplegic side were significantly improved in MDSS group compared with conventional rehabilitation group(both P<0.05).The F wave amplitude of median nerve on the hemiplegic side was positively correlated with MAS score of thumb flexor on the hemiplegic side in MDSS group and conventional rehabilitation group before and after treatment(P<0.05).Conclusion :1.A short course of routine rehabilitation can significantly reduce the flexor spasm on the hemiplegic side of stroke,and then help to improve the motor function and daily living ability of stroke patients on the hemiplegic side.2.MDSS combined with conventional rehabilitation therapy has more advantages in relieving flexor spasm of hemiplegic side after stroke than single conventional rehabilitation therapy,and is more helpful to improve the motor function and daily living ability of hemiplegic side of stroke patients.Moreover,MDSS treatment has the advantages of less time consuming,simple operation,safety,no obvious side effects,and low cost,so it is suitable for clinical application.3.The F wave amplitude of median nerve on the hemiplegic side of stroke patients is positively correlated with MAS score of thumb flexor on the hemiplegic side,which can be used as an objective indicator to evaluate thumb flexor spasm after stroke.