Study On The Status Of Spinal Motor Neurons And Peripheral Nerves In Stroke Patients Based On Electromyography

Objective The purpose of this study is to investigate the effects of stroke on spinal motor neurons and peripheral nerves by nerve conduction and F-wave detection.We hope that we can find new ideas in view of the movement function in patients with cerebral apoplexy hemiplegia rehabilitation treatment,in order to guide the upper limb movement function in patients with cerebral apoplexy hemiplegia rehabilitation training.Method A total of 12 stroke patients admitted to the rehabilitation medical center of the first affiliated hospital of anhui medical university from October 2017 to December 2018 were selected.All patients had the first onset and had hemiplegia.Course of disease: all the 12 patients had passed the acute stage and were in the convalescent rehabilitation stage,and had received conventional rehabilitation treatment for at least two weeks at the time of data collection,including common drugs in neurology,motor therapy,physical factor therapy and occupational therapy.The Brunnstrom stage of the upper limb of the hemiplegia was IV-V stage.The nerve conduction parameters of the musculocutaneous nerve and median nerve and the median nerve F wave parameters both of the bilateral upper limbs were collected by electromyography/evoked potential meter.Compare and analyze the collected parameters of the healthy and affected side.At the same time,the Fugl-Meyer scale was used to evaluate the motor function of the upper limbs(without hands),and the correlation between the ratio of the hemiplegia andthe contralateral side of the median and musculocutaneous nerve conduction parameters and the motor function of the upper limbs of the affected side were analyzed.Results1,Characteristics of motor nerve conduction: (1)The median nerve conduction velocity of the affected side was slower(P<0.05)than the healthy side,when the stimulation site is the wrist.(2)The CMAP latency of the median nerve in the affected side was longer(P<0.05)than the healthy side,when the stimulation site is the elbow.(3)Compared with the healthy side,the CMAP amplitudes of the hemiplegic musculocutaneous nerve decreased significantly(P<0.05).2,Characteristics of sensory nerve conduction:There was no significant difference in SNAP latency,amplitude and nerve conduction velocity between the bilateral median nerve(P>0.05).3,In 12 stroke patients,the Fugl-Meyer score of the upper limbs(without hands)and the contralateral/contralateral ratio of the parameters related to median and musculocutaneous conduction were analyzed by Pearson correlation.The results showed no correlation(P>0.05).4,The incidence of F wave in the median nerve of the stroke patients was increased compared with the contralateral side,and the difference was statistically significant(P<0.05).Conclusion Stroke can lead to axonal degeneration and myelin changes in the upper limbs of the affected limb,and also affect the excitability of spinal motor neurons in the motor unit.The effect of cerebral apoplexy on the sensory nerve of the affected side needs to be further studied.