三维动态捕捉系统结合表面肌电在脑卒中偏瘫患者上肢运动功能评估中的应用

doi:10.3969/j.issn.1006-9771.2022.11.001

Abstract

Abstract:

Objective To analyze the kinematic and physiological characteristics of upper limb reaching task for stroke patients and healthy subjects using three-dimensional (3D) dynamic capture system combined with surface electromyography (sEMG) system, to explore the value of evaluation for upper limb motor function in stroke patients.

Methods From January to August, 2019, Qualisys 3D dynamic capture system and sEMG were used to evaluate 40 healthy adults (control group), and 40 stroke patients with hemiplegia with upper limb and hand Brunnstrom stage of Ⅴ, modified Ashworth Scale score ≤ 1 (hemiplegia group) from Beijing Bo'ai Hospital, during target reaching test with hemiplegic or dominant upper limbs. 3D motion angle of shoulder, elbow, wrist and forearm, and root mean square (RMS) of sEMG of related muscles were recorded. The correlation between the results of the hemiplegia group and Fugl-Meyer Assessment-Upper Extremities (FMA-UE) score was analyzed with Pearson coefficient and multiple linear regression.

Results The shoulder pronation and flexion, elbow extension, wrist flexion and ulnar deviation of the hemiplegia group increased compared with thoses of the control group (|t| > 2.321, P< 0.05), while the shoulder adduction and forearm pronation decreased (|t| > 6.426, P< 0.001). There was no significant correlation between the range of motion of upper limb joints and FMA-UE scores in the hemiplegia group (P> 0.05). The RMS of upper trapezius, anterior deltoid, middle deltoid, biceps brachialis, pectoralis major, pronator teres, brachioradialis and extensor digitalis was less in the hemiplegia group than in the control group (|t| > 2.068, P< 0.05), while it was more of triceps (t = -2.652, P< 0.05). The RMS of the upper trapezius negatively correlated with the FMA-UE scores in the hemiplegia group (r = -0.585, P< 0.001), and the RMS of the pronator teres of positively correlation (r = 0.589, P< 0.001). The RMS of the upper trapezius and the pronator teres was the independent factors related with FMA-UE scores (P< 0.01).

Conclusion 3D dynamic capture system combined with sEMG can be an objective and quantitative method to evaluate upper limb motor function in stroke patients.

Key words: stroke, three-dimensional dynamic capture system, surface electromyography, upper limb, motor function

CLC Number:

R743.3

LI Jingyue,ZHANG Tong,WANG Ya'nan,WANG Chen. Application of three-dimensional dynamic capture system and surface electromyography in upper extremity motor evaluation for stroke patients with hemiplegia[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(11): 1241-1246.

Figures/Tables 6

References 39

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项目	n	性别(男/女)/n	年龄/岁	利手(左/右)/n
对照组	40	18/22	64.63±4.87	4/36
偏瘫组	40	23/17	64.80±5.88	2/38
χ²/t值		1.251	-0.145	0.721
P值		0.263	0.885	0.675

关节运动	对照组(n = 40)	偏瘫组(n = 40)	t值	P值
肩关节内旋	3.09±2.31	43.63±4.82	-47.988	< 0.001
肩关节屈曲	-138.48±1.40	-150.34±6.76	10.890	< 0.001
肩关节内收	51.75±8.15	29.69±7.85	12.330	< 0.001
肘关节伸展	145.67±0.94	152.50±8.23	-3.648	< 0.001
腕关节屈曲	-33.83±16.11	-40.14±6.05	2.321	0.024
腕关节尺偏	0.06±12.50	11.93±25.85	-2.613	0.011
前臂旋前	48.47±2.47	40.02±7.94	6.426	< 0.001

关节运动	r值	95%CI	P值
肩关节内旋	0.133	-0.198~0.410	0.415
肩关节屈曲	-0.246	-0.462~-0.014	0.126
肩关节内收	-0.161	-0.465~0.164	0.320
肘关节伸展	-0.050	-0.344~0.227	0.757
腕关节屈曲	0.172	-0.087~0.429	0.289
腕关节尺偏	-0.287	-0.521~0.040	0.073
前臂旋前	-0.067	-0.336~0.254	0.683

肌肉	对照组(n = 40)	偏瘫组(n = 40)	t值	P值
上斜方肌	235.49±73.19	103.11±53.68	9.206	< 0.001
三角肌前部	287.70±89.26	160.04±102.63	5.936	< 0.001
三角肌中部	248.27±93.09	100.45±63.14	8.311	< 0.001
三角肌后部	52.94±21.52	53.00±44.02	-0.008	0.993
肱二头肌	42.48±10.99	36.21±15.69	2.068	0.042
肱三头肌	33.52±23.81	46.97±21.49	-2.652	0.010
胸大肌	106.69±30.69	46.86±14.38	11.164	< 0.001
旋前圆肌	13.29±4.32	10.61±3.92	2.908	0.005
肱桡肌	28.42±14.19	17.99±8.25	4.025	< 0.001
指伸肌	92.92±49.63	34.96±19.07	6.894	< 0.001

肌肉	r值	95%CI	P值
上斜方肌	-0.585	-0.768~-0.340	< 0.001
三角肌前部	-0.171	-0.537~0.225	0.291
三角肌中部	-0.229	-0.576~0.179	0.154
三角肌后部	-0.060	-0.453~0.330	0.713
肱二头肌	0.184	-0.045~0.449	0.257
肱三头肌	0.067	-0.202~0.383	0.683
胸大肌	-0.051	-0.379~0.245	0.755
旋前圆肌	0.589	0.362~0.765	< 0.001
肱桡肌	-0.162	-0.432~0.242	0.318
指伸肌	0.035	-0.277~0.426	0.830

Application of three-dimensional dynamic capture system and surface electromyography in upper extremity motor evaluation for stroke patients with hemiplegia

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自变量	B	标准误	β	t值	P值
(常量)	51.876	1.818		28.529	< 0.001
上斜方肌	-0.026	0.008	-0.407	-3.119	0.004
旋前圆肌	0.366	0.115	0.416	3.180	0.003

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