SEMG Assessment Of Wrist And Hand Dysfunction Recovery By Computer-assisted Motion Feedback Training In Post-stroke Patients

1.BackgroundStroke is a common disease with high prevalence in the clinic.Limb motor dysfunction is the most common functional defect after onset,about 65%of patients still have hand motor dysfunction 6 months after onset.Unilateral hand movement dysfunction will result in a loss of overall function as much as 27%,seriously affecting the living quality of patients.Therefore,exploring effective treatments and accurate assessment methods is critical for hand motor function rehabilitation.Therefore,this study intends to use computer-assisted motion feedback training to treat patients with post-stroke hand dysfunction,and observe the improvement of hand motor function,activities of daily living and surface electromyography(sEMG)data before and after treatment.On this basis,the correlation between the evaluation scale and the sEMG data is analyzed,which provides a basis for the application of sEMG in the assessment of hand motor dysfunction.2.ObjectivesThis study aimed to explore the effects of the computer-assisted motion feedback training on the hand dysfunction in patients after stroke and observe the application of sEMG in the evaluation of hand motor function in patients with hemiplegia after stroke.3.Subjects and methods3.1 SubjectThe selected subjects were 46 patients with stroke who were hospitalized in the Rehabilitation and Neurology Medicine Department of in ZhuJiang Hospital from January 2018 to August 2018.They were divided into experimental group(23 cases)and control group(23 cases)according to random number table.3.2 Treatment planTwo groups of patients were given basic drug therapy and rehabilitation therapy.Based on the basic treatment,the trial group accepted computer-assisted motion feedback training,while the control group accepted routine rehabilitation of hand function.All participants received treatment for 4 weeks(30 mins/time,l time/day,5 days/week).3.3 Assessment methodsBefore and after treatment,the sEMG data such as the root mean square(RMS)and integrated electromyography(iEMG)of wrist flexor(WF),wrist extensor(WE),extensor digitorum(ED),abductor pollicis brevis(APB)were collected,and the function of patients were assessed by the Fugl-Meyer Assessment Scale(FMA),Brunnstrom Assessment Scale,modified Ashworth scale(MAS)and modified Barthel Index(MBI).3.4 Statistical analysisSPSS 20.0 statistical software was used for data processing.The significance level was set at p<0.05,and the data was expressed as(x±s)or M(Qu-QL),the difference of measurement data was compared with independent sample t-test between the two groups,Paired t-test was used in the group before and after treatment,Wilcoxon rank sum test or Wilcoxon symbolic rank test was used if the data variance was not uniform or did not comply with the normal distribution.Pearson correlation coefficient or spearman correlation coefficient was used to analyze the correlation between parameters.The sEMG data were taken as independent variables for multiple stepwise regression analysis.Shedding cases data were analyzed according to the intention-to-treat principle.4.Results4.1 A total of 43 patients completed the experiment(There were 2 cases in the experimental group and 1 case in the control group was detached).The FMA score,MBI score,the root mean square(RMS)and integrated electromyography(iEMG)of the WF,WE,ED,APB improved in the control group after training(P<0.05).The FMA score,MAS score,MBI score,the RMS and iEMG of WF,ED,APB improved in the trial group after training(P<0.05).The trial group's total score of FMA,hand Subscales of FMA score,MBI score,RMS of WE and iEMG of ED were higher than the control Group after training(P<0.05),and there was no significant difference between two groups in other indicators(P>0.05).4.2 The FMA score has significant positive correlation with the RMS,iEMG value of WF,WE,ED,APB(r=0.423-0.732,all P<0.05);Brunnstrom grade has significant positive correlation with the RMS value of WE,ED,ABP(r =0.343-0,467,all P<0.05)and the iEMG value of WF,WE,ABP(r= 0.223?0.328,all P<0.05).5.Conclusion5.1 Computer-assisted motion feedback training is effective for the improvements of hand function and activities of daily living in patients after stroke.5.2 sEMG is an effective tool to evaluate the motor function of hand for stroke patient as an objective and quantitative assessment method.The sEMG signals of WE,ED are more closely related to the hand motor function scores and it is more suitable for clinical hand motor function evaluation.