Clinical Study Of Lower Extremity Spasticity Assessment In Hemiplegic Patients During The Recovery Stage Of Stroke With Surface Electromyography

Objective: Most stroke patients will have varying degrees of spasticity in the process of recovery of motor function. At present, Modified Ashworth Scale(MAS) and Composite Spasticity Scale(CSS) are universally adopted clinically, and other comprehensive ability scales are used in supplement in the meantime, to reflect the severity of spasm.But, these methods are unable to objectively and quantitatively evaluate the severity of spasm.After the stroke patients’ upper motoneurons are damaged, the spinal cord will lose the control of upper center, which will lead to the activity change of segmental motoneurons and central neurons, and even the change of relevant electroneurophysiology. Surface Electromyography(s EMG) can reflect the muscle’s myoelectric activity, whether static state or dynamic state. In summary,the study is rare on s EMG on the passive movement of limbs of stroke patients during the recovery stage as well as MAS and CSS to scale the spasticity of limbs. Therefore,this paper makes an exploration of more objective and quantitative evaluating methods of muscular spasm of stroke patients during the recovery stage, in the meantime, it also expands the clinical application scope of s EMG.Methods: 32 paralysis patients during the recovery stage of stroke were chosen, 20 patients with cerebral infarction,cerebral hemorrhage in 12 patients,duration of 3 to 12 weeks,while FMA scale was adopted to evaluate the movement function of both lower limbs of the paralysis patients during the recovery stage of stroke, muscle tone was evaluated by means of MAS and CSI, the surface myoelectricity characteristics ofboth lower limbs gastrocnemius were recorded with s EMG, the changes of H reflex on both sides were compared, and the incubation period of H reflex and the ratio of H/M on the affected side as well as the ratio of H/M of the lower limbs on the affected side and the relations between MAS evaluation, CAS evaluation, and FMA evaluation were analyzed.Results: The incubation period of H reflex on the affected side was24.91±1.37 ms on average, the amplitude of H reflex was 7.05±0.32 u V on average,and the ratio of H/M was 0.47±0.08 on average. The incubation period of H reflex on the unaffected side was 29.74±2.18 ms on average,the amplitude of H reflex was 3.80±0.39 u V on average,and the ratio of H/M was 0.21±0.02 on average. If the incubation period and the ratio of H/M on both sides were compared, it could be seen that the incubation period on the affected side was shortened, while the ratio of H/M increased, and there were significant differences(P﹤0.05); the value of CSS evaluation and H/M were in positive correlation(P ﹤ 0.05),the correlation coefficient was r=0.706;the value of MAS evaluation and H/M were in positive correlation(P﹤0.05),and the correlation coefficient was r=0.741;the value of FMA evaluation and H/M were in negative correlation( P﹤0.05),and the correlation coefficient was r=–0.696.Conclusion: Surface electromyography detection can better reflect the recovery of stroke patients with hemiplegia lower limb motor dysfuction cases; the ratio of H/M in H reflex can be used as the sensitive index to evaluate the electrophysiology of the stroke patients, which can be used to evaluate the spasticity of the stroke patients.