| Objective: The surface EMG signals of the upper and lower limb muscles of hemiplegic patients at different stages of stroke recovery were collected to quantitatively assess the activation,recruitment and fatigue of the target muscles on the hemiplegic side at different stages of recovery,and to make relevant analysis and research on the EMG characteristics of the target muscles to provide reference for precise rehabilitation training.Methods: For stroke patients who met the inclusion and exclusion criteria and were hospitalised in our hospital,15 patients were selected from each of the stages from Brunnstrom Ⅱ to Brunnstrom Ⅴ according to the Brunnstrom stage classification and divided into 4 groups,15 patients in stage Ⅱ(group A),15 patients in stage Ⅲ(group B),15 patients in stage Ⅳ(group C)and 15 patients in stage V(group D),a total of 60 patients.The Integrate electromyography(iEMG)and Mean power frequency(MPF)of biceps brachii(BB),triceps brachii(TB),trapezius(TZ),deltoid(DT),rectus femoris(RF),Vastus latrrilis(VL),Tibialis anterior(TA)and Gastrocnemius(GM)were collected from the affected side and the healthy side of the patients in the four groups during the performance of the prescribed movement task.The iEMG and MPF values of the eight muscles on the affected side of the stroke were compared between the groups and to analyse the electromyographic characteristics of the muscles on the hemiplegic side at different stages of stroke recovery.Results:(1)Comparison of iEMG values of target muscles in the upper limbs of the 4groups: iEMG of the affected biceps in stages Ⅱ,Ⅲ and Ⅳ was significantly smaller than that of the healthy side,with a statistically significant difference(P<0.05).iEMG of the affected biceps in stage Ⅴ was smaller than that of the healthy side,but there was no statistical difference(P=0.51).The iEMG of the affected biceps muscle was statistically different between the four groups(P<0.05).The iEMG of the affected triceps in stages Ⅱ and Ⅲ was significantly smaller than that of the healthy side,with a statistically significant difference(P<0.05),the iEMG of the affected triceps in stage Ⅳ was larger than that of the healthy side,with a statistically significant difference(P<0.05),and the iEMG of the affected triceps in stage Ⅴ was smaller than that of the healthy side,but there was no statistically significant difference(P=0.37).In a two-by-two comparison of the iEMG of the affected triceps in the four groups,there was no statistical difference between stage Ⅲ and V(P=0.455),while the rest of the stages were different(P<0.05).The iEMG of the affected middle deltoid bundle in stages Ⅱ,Ⅲ and Ⅳ was significantly smaller than that of the healthy side,with a statistically significant difference(P<0.05),and the iEMG of the affected middle deltoid bundle in stage Ⅴ was larger than that of the healthy side,with a statistically significant difference(P<0.05).iEMG of the affected middle deltoid bundle in all four groups was statistically different when compared between the two groups(P<0.05).The iEMG of the affected upper trapezius muscle was greater than that of the healthy side in stages Ⅱ,Ⅲ and Ⅳ,with a statistically significant difference(P<0.05).When comparing the iEMG of the affected upper trapezius muscle between the four groups,there was no statistically significant difference between stages Ⅲ and Ⅳ(P=0.433),while the remaining stages differed between the two(P<0.05).(2)Comparison of MPF values of target muscles in the upper limbs of the four groups:The MPF of the affected biceps in stages Ⅱ,Ⅲ and Ⅳ was smaller than that of the healthy side,and the difference was statistically significant(P<0.05),while the MPF of the affected biceps in stage Ⅴ was not statistically significant compared to that of the healthy side(P=0.35),In a two-by-two comparison of the MPF of the affected biceps in the four groups,there was no statistical difference between stage Ⅲ compared to stage Ⅳ(P=0.054),and the remaining stages differed between the two(P<0.05).There was no statistical difference in the MPF of the affected triceps compared to the healthy side in stage Ⅱ(P=0.08),and in the remaining stages there was a difference in the MPF of the affected triceps compared to the healthy side in all stages(P<0.05),but there was no difference in the MPF of the affected triceps in both stages(P>0.05).The MPF of the affected middle deltoid bundle in stages Ⅲ and Ⅳ were different compared to the healthy side(P<0.05),but the MPF of the affected middle deltoid bundle in stages Ⅱ and Ⅴ did not show any significant difference compared to the healthy side(P>0.05),and when the MPF of the affected middle deltoid bundle was compared between the four groups,only stage Ⅱ was statistically different compared to the other stages(P<0.05).There was no difference between the two groups(P>0.05).The MPF of the affected upper trapezius muscle in stages Ⅲ and Ⅴ was different from that of the healthy side(P<0.05),while the MPF of the affected upper trapezius muscle in stages Ⅱ and Ⅳ was not significantly different from that of the healthy side(P>0.05).There was no difference in the MPF of the affected upper trapezius muscle in stage Ⅱ compared to stage Ⅲ(P=0.332).(3)Comparison of iEMG values of the target muscles of the lower limbs of the 4 groups: The iEMG of the affected rectus femoris,Vastus latrrilis and tibialis anterior muscles in stages Ⅱ,Ⅲ,Ⅳ and Ⅴ differed compared to the healthy side(P<0.05).When the iEMG values of the affected rectus femoris in the four groups were compared between the two groups,they differed between the two groups(P<0.05),except for the iEMG of the affected rectus femoris in stages Ⅱ and Ⅲ,which did not differ significantly(P=0.095).The iEMG of the affected gastrocnemius muscle in stages Ⅱ,Ⅲ and Ⅳ compared to the healthy side was different(P<0.05),but the iEMG of the affected gastrocnemius muscle in stage Ⅴ compared to the healthy side was not significantly different(P=0.35).In a two-by-two comparison of the MPF of the affected gastrocnemius muscle in the four groups,there was no difference in stage Ⅱ compared to stage Ⅲ(P=0.58),while the remaining stages were different in a two-by-two comparison(P<0.05).(4)Comparison of MPF values of the target muscles of the lower limbs of the 4 groups: The MPF of the affected rectus femoris and tibialis anterior muscles in stages Ⅱ,Ⅲ,Ⅳ and Ⅴ were all different compared to the healthy side(P<0.05),and the MPF of the affected Vastus latrrilis muscles in stages Ⅱ,Ⅲ and Ⅳ were different compared to the healthy side(P<0.05),but no significant difference was seen in the MPF of the affected Vastus latrrilis muscles in stage Ⅴ compared to the healthy side(P=0.51),and the MPF of the affected gastrocnemius muscles in all four groups compared to the There was no difference in the MPF of the affected gastrocnemius compared to the healthy side in all four groups(P>0.05).When the MPF of the rectus femoris muscle on the affected side was compared between the 4 groups,there was no difference in the MPF of the rectus femoris muscle on the affected side in stage Ⅳ compared to stage V(P=0.071),there was a difference in the MPF of the Vastus latrrilis and tibial anterior muscles between the 4 groups(P<0.05)and there was no statistical difference in the MPF of the masticatory muscle between the 4 groups(P=0.69).Conclusions:(1)The over-activation of the affected upper trapezius muscle and the significant activation of the affected triceps muscle at all stages of stroke were shown to compensate for the under-activation of the affected biceps and deltoid muscles during the completion of the experimental movement task,and the amount of muscle synergy and proper coordination of muscle activity in the affected upper limb was more pronounced with increasing Brunnstrom stages.(2)At the completion of the experimental movement task,the muscle power output of the affected lower limb was significantly impaired at all stages of stroke and the degree of impairment correlated with the degree of hemiparesis,with the number of target muscles recruited in the affected lower limb gradually increasing and the degree of fatigue improving with increasing Brunnstrom’s stage.(3)The s EMG provides an objective assessment of the characteristic changes in the muscles of the hemiplegic side at different stages of recovery after stroke and provides a reference for rehabilitation training to efficiently address the functional impairment of the affected limb. |
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