Application Of Surface Electromyography In The Assessment Of Triceps Spasm In Children With Spastic Cerebral Palsy And Pointy Foot

Objective To analyze the correlation between surface electromyography values of gastrocnemius and solium muscle and modified Ashworth grade,PROM and GMFM-88 in children with spastic cerebral palsy and apical foot,and to explore whether surface electromyography can quantitatively evaluate muscle spasm and the difference of influence of gastrocnemius and solium muscle on the degree of spasm and motor function of the whole limb.In order to provide objective and quantitative reference for rehabilitation evaluation and treatment of children with cerebral palsy apical foot.Method Sixty children with spastic cerebral palsy apical foot who met the inclusion criteria were selected and evaluated by the same tester for MAS,PROM and GMFM-88(D+E area).Meanwhile,root mean square(RMS)values of surface electromyographic signals of gastnemius and soles were recorded in resting state and passive draft state.The correlation between MAS,PROM,GMFM-88(D+E region)and the surface EMG value of gastrocnemius and soleus muscle was analyzed by Spearman.Results At resting state,gastrocnemius surface electromyography(RMS)was positively correlated with MAS grading,and soleus surface electromyography(RMS)was also positively correlated with MAS grading.Under passive drafting,the surface electromyography RMS of gastrocnemius muscle was positively correlated with MAS grading,and the surface electromyography RMS of soleus muscle was also positively correlated with MAS grading.Spearman correlation analysis showed that:(1)the surface EMG RMS of gastrocnemius(r=0.638)and soleus(r=0.476)were positively correlated with MAS at resting state(P<0.05);The surface electromyographic value(RMS)of gastrocnemius(r=0.922)and soleus(r=0.550)was positively correlated with MAS under passive drafting condition(P<0.05).(2)At resting state,the surface electromyography(RMS)of gastrocnemius(r=0.621)and soleus(0.359)were positively correlated with PROM(P<0.05).In passive drafting state,the surface electromyographic value(RMS)of gastrocnemius(r=0.930)and soleus(r=0.442)was positively correlated with PROM(P<0.05).(3)At resting state,the surface electromyography RMS of gastrocnemius(r=-0.512)and soleus(r=-0.381)were negatively correlated with GMFM-88(D+E region)(P<0.05).In passive drafting state,the surface electromyography RMS of gastrocnemius(r=-0.836)and soleus(r=-0.685)were negatively correlated with GMFM-88(D+E region)(P<0.05).Conclusion(1)In children with spastic cerebral palsy with apical foot,the RMS value of surface electromyography was positively correlated with MAS grade regardless of resting or passive drafting status,and the detection of spasm under passive drafting status was more accurate.Surface electromyography could be used as an objective and quantitative evaluation method for spasm.(2)The surface electromyography RMS of gastrocnemius and soleus were correlated with MAS,PROM and GMFM-88(D+E region)in both resting and passive drafting states,and the correlation between the surface electromyography RMS of gastrocnemius and soleus was higher than that of MAS,PROM and GMFM-88(D+E region).Gastrocnemius is the main responsible muscle for triceps spasm of the calf in children with cerebral palsy and gastrocnemius spasm is the main factor leading to pointy foot status and movement dysfunction in children with cerebral palsy.(3)Surface electromyography can provide quantitative and objective scientific basis for the rehabilitation assessment and the formulation of rehabilitation programs for children with cerebral palsy apical foot.