Study On The Changes Of Surface Electromyography Signal After The Achilles Tendon Lengthening In Children With Spastic Cerebral Palsy

Objective: To evaluate the effects of Achilles tendon lengthening on talipes equinus in children with spastic cerebral palsy by comparing the preoperative with postoperative surface electromyography(s EMG)signals.And provide reference for further surgical treatment or rehabilitation training,and to improve the quality of children's lives.Methods: From March,2016 to January,2017,twenty-six spastic cerebral palsy children with talipes equinus(43 feet)received Achilles tendon lengthening in the People's Hospital of Hunan Province.Ankle dorsiflexion range of motion(ROM)and surface electromyography from tibialis anterior and medial head of gastrocnemius were measured before,6 months and 12 months after operation,respectively.Degree of gastrocnemius spasm of passive and active dorsiflexion,root mean square(RMS)of tibia muscle group and co-contraction ratio(CR)when active dorsiflexion,standing on foot and standing were compared.Results: 1.The ROM of ankle passive dorsiflexion increased obviously 6months and 12 months after operation,while the RMS of gastrocnemius muscle decreased obviously when ankle passively dorsiflex(p<0.01).And the RMS of gastrocnemius muscle increased 12 months compared with 6months after operation(p<0.01).2.The ROM of ankle active dorsiflexion increased obviously 6 months and 12 months after operation.The RMS of tibialis anterior musclechanged little when ankle actively dorsiflex(p>0.05).3.The RMS of gastrocnemius muscle when standing on foot increased obviously 6 months and 12 months after operation compared with the preoperative(p<0.01).4.The RMS of tibialis anterior muscle when standing decreased after operation(p<0.05),while the long peroneal muscle's changed little(p>0.05).The RMS of gastrocnemius muscle when standing increased 6 months after operation(p<0.05),but there was no statistical significance between before and 12 months after operation(p>0.05).5.The CR of tibialis anterior and gastrocnemius muscle when standing changed obviously after operation,while there was no distinct difference between 6 months and 12 months after operation(p>0.05).Conclusion: 1.Achilles tendon lengthening can improve the coordination of tibia muscle group to reduce muscular tension and increase the ROM of ankle for children with talipes equinus after spastic cerebral palsy.2.The sEMG is feasible to guide the targeted rehabilitation training of children and improve motor function and the quality of their lives.