推拿手法对脑卒中患者表面肌电信号的影响

doi:10.3969/j.issn.1006-9771.2017.07.015

Abstract

Abstract: ObjectiveTo compare the effect of various manipulation of Tuina on surface electromyogram (sEMG) in hemiplegics after stroke. MethodsFrom January to May, 2016, 20 inpatients with hemiplegia after stroke accepted Tuina on bilateral rectus femoris by the same therapist, with the techniques of rolling, patting, rubbing, shaking, kneading and pressing, one minute a manipulation and interval one minute. Integrated electromyography (iEMG), root mean square (RMS) and median frequency (MF) of sEMG were compared, both in rest and during Tuina. ResultsThere was no significant difference of iEMG, RMS and MF between affected and unaffected sides in rest (t<1.147, P>0.05). iEMG and RMS were the most under patting (F>21.376, P<0.001), and MF was the highest under pressing (F>11.772, P<0.001). iEMG, RMS and MF were not very different under other manipulation (P>0.05). iEMG and RMS were less in the affected side than in the unaffected side under patting (P<0.05). ConclusionVarious manipulation of Tuina may be different in neuromuscular stimulation, that patting may stimulate more muscles and motor units.

Key words: stroke, hemiplegia, Tuina, manipulation, surface electromyogram

CLC Number:

R743.3

LIAO Ruo-yi, ZHANG Ting, CAI Hua-an, ZHANG Yue-juan, PENG Ting-yun, CHEN Qian-yu, FAN Bing-qian, GUI Yi-sha, YIN Zhen-zhen. Variation of Surface Electromyogram with Manipulation of Tuina for Stroke Hemiplegics[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2017, 23(7): 807-810.

References

[1] 付露,潘文宇. 中风后痉挛性瘫痪的针灸推拿及康复治疗现状[J]. 现代中西医结合杂志, 2016, 25(10): 1137-1139.
[2] 陈峰,苏庆军. 穴位推拿结合抗痉挛技术对脑卒中后上肢肌痉挛改善的疗效观察[J]. 中国实用神经疾病杂志, 2011, 14(1): 74-75.
[3] 饶明俐. 中国脑血管病防治指南[M]. 北京:人民卫生出版社, 2007: 37-54.
[4] 国家中医药管理局全国中医脑病急症科研协作组.中风病诊断与疗效评定标准[J]. 北京中医药大学学报, 1996, 19(1): 55-56.
[5] 国家中医药管理局中医师资格认证中心. 中西医结合执业助理医师医师资格考试大纲[M]. 北京:中国中医药出版社, 2015: 145-160.
[6] 安媛. 手指活动影响前臂多腱肌运动单元募集模式的初步研究[D]. 重庆：重庆大学生物医学工程系, 2012.
[7] Pereira LM, Marcucci FC, de Oliveira Menacho M, et al. Electromyographic activity of selected trunk muscles in subjects with and without hemiparesis during therapeutic exercise [J]. J Electromyogr Kinesiol, 2011, 21(2): 327-332.
[8] Stock MS, Drusch AS, Thompson BJ. The minimum number of contractions required to examine the EMG amplitude versus isometric force relationship for the vastus lateralis and vastus medialis [J]. J Electromyogr Kinesiol, 2014, 24(6): 827-834.
[9] Zhu W, Zheng G, Gu Y, et al. Clinical efficacy and sEMG analysis of a new traditional Chinese medicine therapy in the treatment of spasticity following apoplectic hemiparalysis [J]. Acta Neurol Belg, 2014, 114(2): 125-129.
[10] Daly JJ, Roenigk K, Cheng R, et al. Abnormal leg muscle latencies and relationship to dyscoordination and walking disability after stroke [J]. Rehabil Res Prac, 2011, 2011: 313980.
[11] Kallenberg LA, Hermens HJ. Motor unit properties of biceps brachii during dynamic contractions in chronic stroke patients [J]. Muscle Nerve, 2011, 43(1): 112-119.
[12] Minetto MA, Botter A, Lanfranco F, et al. Muscle fiber conduction slowing and decreased levels of circulating muscleproteins after short-term dexamethasone administration in healthy subjects [J]. J Clin Endocrinol Metab, 2010, 95(4): 1663-1671.
[13] 郑萍,吴春微. 表面肌电在脑卒中偏瘫患者肢体功能评测中的应用[J]. 现代中西医结合杂志, 2013, 22(18): 1966-1968.
[14] 谭志梅,姜文文,燕铁斌,等. 基于正常行走模式的功能性电刺激对脑卒中恢复期患者行走功能的影响[J]. 中华医学杂志, 2016, 96(29): 2342-2346.
[15] Wu LP, Huang YQ, Zhou WH, et al. Influence of cervical spine position, turning time, and cervical segment on cadaver intradiscal pressure during cervical spinal manipulative therapy [J]. J Manipulative Physiol Ther, 2012, 35(6): 428-436.
[16] 潘化平,冯慧,李亚娟,等. 疏经通督推拿结合康复训练对脑卒中患者偏瘫肢体运动能力的影响[J]. 中国中西医结合杂志, 2011, 31(11): 1474-1478.
[17] 汪菲,何晴,李建华. 表面肌电在中枢神经系统疾病肌痉挛患者评价中的研究现状[J]. 中国康复医学杂志, 2016, 31(11): 1277-1280.
[18] 程华军,陈尚杰,许琼瑜,等. 步态诱发功能性电刺激同步减重平板训练对脑卒中患者下肢表面肌电信号的影响[J]. 新医学, 2016, 47(10): 686-690.
[19] 杨唐柱,黄晓琳,熊蔡华,等. 偏瘫患者与正常人在五项日常生活活动中的表面肌电分析[J]. 中国康复医学杂志, 2011, 26(3): 236-239, 250.
[20] 樊留博,刘素芝,韩文胜,等. 脑卒中后痉挛性偏瘫患者膝关节控制能力障碍的sEMG特征研究[J]. 中华全科医学, 2016, 14(5): 715-717.
[21] 徐嘉,谢利. 表面肌电图对卒中病人患侧下肢肌张力评价的研究[J]. 中国伤残医学, 2012, 20(2): 5-7.
[22] 夏清,袁海,王修敏,等. 表面肌电在脑卒中患者肢体功能障碍评价中的意义[J]. 中国康复医学杂志, 2013, 28(11): 1046-1048.
[23] 廖志平,魏爽,李建华,等. 表面肌电图评估技术在脑卒中患者下肢肌肉领域的应用[J]. 中国康复, 2015, 30(5): 388-390.
[24] 王培,王红星. 神经电生理检测技术在脑卒中后功能评定中的应用进展[J]. 中国康复理论与实践, 2016, 22(12): 1404-1407.

Variation of Surface Electromyogram with Manipulation of Tuina for Stroke Hemiplegics

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

References

Related Articles 15

Metrics

Comments

Recommended 0

[1]	LIN Na, GAO Hanlu, LU Huiping, CHEN Yanqing, ZHENG Junfan, CHEN Shurong. Effect of virtual reality on upper limb function after stroke: a study of diffusion tensor imaging [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2024, 30(1): 61-67.
[2]	WANG Haoyi, SHI Yawei, LU Jun, XU Guangxu. Impact of subjective vertical perception impairment on function in stroke patients: a retrospective study [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2024, 30(1): 68-73.
[3]	CHEN Junwen, CHEN Qian, CHEN Cheng, LI Shuyue, LIU Lingling, WU Cunshu, GONG Xiang, LU Jun, XU Guangxu. Effect of modified Baduanjin exercise on cardiopulmonary function, motor function and activities of daily living for stroke patients [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2024, 30(1): 74-80.
[4]	HU Yonglin, MA Ying, DOU Chao, LU Anmin, JIANG Xiaoge, SONG Xinjian, XIAO Yuhua. Effect of neural mobilization based on shoulder control training on shoulder pain and upper limb function in stroke patients with hemiplegia [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2024, 30(1): 81-86.
[5]	WANG He, HAN Liang, KAN Mengfan, YU Shaohong. Efficacy of electrical stimulation on shoulder-hand syndrome after stroke: a systematic review and meta-analysis [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(9): 1048-1056.
[6]	HU Xiaoshi, ZHANG Qi, YUE Qing, LIANG Yanhua, LI Xiaosong, FENG Amei, ZHANG Yanqing. Effect of orthopedic elastic bandages on gait symmetry and walking ability in children with spastic hemiplegic cerebral palsy [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(9): 1083-1089.
[7]	SUN Tengfang, REN Mengting, YANG Lin, WANG Yaoting, WANG Hongyu, YAN Xingzhou. Effect of hyperbaric oxygen therapy combined with repetitive peripheral magnetic stimulation on ankle motor function and balance of stroke patients [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 875-881.
[8]	WANG Ya'nan, LIU Xihua. Correlation and predictive effect of subjective and objective balance function measurements in stroke patients with hemiplegia [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 890-895.
[9]	WANG Haiyun, WANG Yin, ZHOU Xinjie, HE Aiqun. Effect of transcranial direct current stimulation combined with acupuncture on central and upper limb function in stroke patients based on central-peripheral-central theory [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 919-925.
[10]	CHEN Yiting, WANG Qian, CUI Shenhong, LI Yingcai, ZHANG Siyu, WEI Yanxu, REN Hui, LENG Jun, CHEN Bin. Effect of bilateral sequential repetitive transcranial magnetic stimulation on motor function of upper limbs in stroke patients [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 926-932.
[11]	LI Zhenya, SUN Jie, GUO Pengfei, WANG Guangming. Correlation between changes of swallowing function in oral and pharyngeal phases, and aspiration in stroke patients based on videofluroscopic swallowing study [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 933-939.
[12]	HUA Ling, ZHANG Yi'nan, ZHENG Yu, SUN Qiaoyi, FANG Hui, SONG Da. Effect of hand controlled rhythm music therapy on unilateral spatial neglect after stroke [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(7): 833-838.
[13]	JIANG Xiaocui, LIU Zhen, SU Qinglun, ZHAO Qin, XIA Xiaomei, LU Fei. Effect of intermittent theta burst transcranial magnetic stimulation on non-fluent aphasia after stroke [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(7): 839-843.
[14]	XU Miaomiao, LI Nan, YING Ying, YANG Kaixiang, YANG Jingrui, LI Jie, QIU Yanqun. Effect of repetitive peripheral magnetic stimulation on upper limb motor function of stroke patients after contralateral seventh cervical nerve transfer [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(6): 686-690.
[15]	ZHENG Li, BAO Zhicheng, ZHANG Qi, REN Xuyan, SU Min. Effect of transcutaneous auricular vagus nerve stimulation combined with robot-assisted therapy on upper limb function of stroke patients [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(6): 691-696.