Quantitative Analysis Of Spastic Triceps Surae In Stroke Patients With Surface Electromyography

Objective:To relate the results of surface electromyography(s EMG)of the gastrocnemius among patients with hemiplegia after stroke with scores on the modified Ashworth scale(MAS)and the composite spasticity scale(CSS),and to decide whether s EMG can be used as a quantitative index for assessing the extent of spasm.Methods:The affected gastrocnemius of thirty-four hemiplegic stroke patients who met the inclusion criteria were evaluated by the same doctor using the MAS and the CSS.Integrated electromyography(i EMG)of s EMGs from the gastrocnemius medialis and gastrocnemius lateralis in resting state and in the process of drawing out passively were extracted.Then the correlationships among these s EMG indexes,the MAS and the CSS were analyzed.Results:The s EMG signals from the gastrocnemius medialis and gastrocnemius lateralis were strongly correlated with the MAS and CSS grading in resting state and in the process of drawing out passively,and they increased with increasing MAS and CSS grade.Spearman correlation analysis showed that when the muscles were in resting state,the i EMG of the gastrocnemius medialis(r=0.746)and the gastrocnemius lateralis(r=0.696)were correlated with MAS(P<0.01),the i EMG of the gastrocnemius medialis(r=0.799)and the gastrocnemius lateralis(r=0.787)were also correlated with CSS(P<0.01);When the muscles were passively drawn,the i EMG of the gastrocnemius medialis(r=0.831)and the gastrocnemius lateralis(r=0.849)were correlated with MAS(P<0.01),the i EMG of the gastrocnemius medialis(r=0.866)and the gastrocnemius lateralis(r=0.858)were also correlated with CSS(P<0.01).Conclusions:Integrated electromyography(i EMG)of s EMG from the gastrocnemius medialis and gastrocnemius lateralis in resting state and in the process of drawing out passively correlate well with MAS and CSS grades,and they increase with increasing MAS and CSS grade.Integrated electromyography(i EMG)of s EMG can be used as an objective and sensitive index for the assessment of clinical muscle tension,so as to provide aquantitative reference for the treatment of stroke patients with hemiplegia spasm.