Application of electrophysiology in rehabilitation evaluation after stroke and its clinical significance
WANG Qinying1, 2, ZHAN Qing1, 2
Author information+
1Department of Neurology, Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai 200137, China；2Department of Neurorehabilitation, Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai 200137, China
Electrophysiology, as a kind of objective, quantitative, noninvasive and repeatable method, plays an irreplaceable role in the rehabilitation assessment of stroke patients. The surface electromyography has been applied especially in kinematic analysis and the evaluation of muscle function. The electroencephalogram can be used to identify the cortical function. Through evoked potential examination, the state of motion, perception and cognition of stoke patients can be assessed. The transcranial Doppler can be used to detect the changes of cerebral blood flow during rehabilitation. It has a positive value in evaluating the functional disturbance of post-stroke patients and making the rehabilitation plan by using electrophysiological techniques. This review summarizes the advances in electrophysiology in rehabilitation evaluation after stroke and its clinical significance.
WANG Qinying, ZHAN Qing.
Application of electrophysiology in rehabilitation evaluation after stroke and its clinical significance[J]. Journal of Neurology and Neurorehabilitation. 2016, 12(3): 161-167 https://doi.org/10.12022/jnnr.2016-0017
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] 吴兆苏, 姚崇华, 赵 冬. 我国人群脑卒中发病率、死亡率的流行病学研究[J]. 中华流行病学杂志, 2003, 24(3):236-239.
[2] THORSéN A M, HOLMQVIST L W, DE PEDRO-CUESTA J, et al. A randomized controlled trial of early supported discharge and continued rehabilitation at home after stroke: five-year follow-up of patient outcome[J]. Stroke, 2005, 36(2):297-303.
[3] 李 芳, 安丙辰, 郑洁皎. 表面肌电图在脑卒中患者手神经肌肉功能评定中的应用[J]. 中国康复理论与实践, 2015, 21(3):280-283.
[4] MALONE A, MELDRUM D, GLEESON J, et al. Reliability of surface electromyography timing parameters in gait in cervical spondylotic myelopathy[J]. J Electromyogr Kinesiol, 2011, 21(6):1004-1010.
[5] WATANABE K, AKIMA H. Validity of surface electromyography for vastus intermedius muscle assessed by needle electromyography[J]. J Neurosci Methods, 2011, 198(2):332-335.
[6] 李 卓, 谢 斌, 罗 春, 等. 脑卒中患者坐位及站立位胫骨前肌和腓肠肌表面肌电图信号特征研究[J]. 中国康复理论与实践, 2007, 13(12):1147-1149.
[7] 吴运景, 朱 江, 刘晓霞, 等. 脑卒中偏瘫患者恢复期康复训练胫骨前肌和腓肠肌表面肌电信号的变化[J]. 心脑血管防治, 2015, 15(3):202-203.
[8] 赵 军, 张 通, 芦海涛, 等. 脑卒中偏瘫步态表面肌电图和动态关节角度分析及康复策略研究[J]. 中国实用内科杂志, 2013, 33(12):948-952.
[9] KLOTER E, WIRZ M, DIETZ V. Locomotion in stroke subjects: interactions between unaffected and affected sides[J]. Brain, 2011, 134(Pt 3):721-731.
[10] 梁 明, 窦祖林, 温红梅, 等. 脑卒中患者肘曲伸肌表面肌电变化与运动功能的相关性[J]. 中华医学杂志, 2014, 94(17):1304-1308.
[11] 孙 栋, 戴慧寒, 蔡奇芳, 等. 脑卒中偏瘫患者股直肌和股二头肌的表面肌电信号特征[J]. 中国康复医学杂志, 2008, 23(3):256-257.
[12] 樊留博, 刘素芝, 韩文胜, 等. 脑卒中后痉挛性偏瘫患者膝关节控制能力障碍的sEMG 特征研究[J]. 中华全科医学, 2016, 14(5):715-717.
[13] PACIARONI M, MAZZOTTA G, COREA F, et al. Dysphagia following stroke[J]. Eur Neurol, 2004, 51(3):162-171.
[14] VAIMAN M. Standardization of surface electromyography utilized to evaluate patients with dysphagia[J]. Head Face Med, 2007, 3(1):26-32.
[15] 韩 婕, 阎文静, 戴玲莉, 等. 表面肌电图在脑卒中吞咽障碍患者康复疗效评估中的应用研究[J]. 中国康复医学杂志, 2013, 28(6):579-581.
[16] 中国吞咽障碍康复评估与治疗专家共识组. 中国吞咽障碍康复评估与治疗专家共识（2013年版）[J]. 中华物理科学与康复杂志, 2013, 35(12):916-929.
[17] MILLER L C, DEWALD J P. Involuntary paretic wrist/finger flexionforces and EMG increase with shoulder abduction load in individuals with chronic stroke[J]. Clin Neurophysiol, 2012, 123(6):1216-1225.
[18] SCHIEBER M H, LANG C E, REILLY K T, et al. Selective activation of human finger muscles after stroke or amputation[J]. Adv Exp Med Biol, 2009, 629:559-575.
[19] TOWLES J D, KAMPER D G, RYMER W Z. Lack of hypertonia in thumb muscles after stroke[J]. J Neurophysiol, 2010, 104(4):2139-2146.
[20] LEE S W, TRIANDAFILOU K, LOCK B A, et al. Impairment in task-specific modulation of muscle coordination correlates with the severity of hand impairment following stroke[J]. PLoS One, 2013, 8(7):e68745.
[21] 李雪萍, 陈安亮, 程 凯, 等. 脑卒中患者前臂表面肌电变化与手功能评定相关性的研究[J]. 神经损伤与功能重建, 2008, 3(6):401-403.
[22] 季晓林, 周秀珍. 脑血管疾病康复治疗过程中的脑电图及诱发电位研究[J]. 临床脑电学杂志, 1997, 6(1):56-58.
[23] 姜建东, 陈俊宁, 杨春水, 等. 出血性脑卒中患者脑电相对功率谱与日常生活活动能力的相关性研究[J]. 临床脑电学杂志, 1994, 3(2):78-79.
[24] 贾应勃, 刘 健, 赵 蕊, 等. 偏瘫早期康复治疗的疗效及脑电图观察[J]. 陕西医学杂志, 2010, 39(12):1650-1651.
[25] 郭晓彦. 早期康复训练对脑缺血患者血流动力学和脑电图及P300的影响[J]. 中国老年学杂志, 2015, 35(8):4323-4324.
[26] 徐朝辉, 元小冬, 申 健, 等. 脑卒中患者急性期康复过程中神经功能和脑电生理的变化[J]. 现代电生理学杂志, 2006, 13(2):77-82.
[27] CHO H Y, KIM K T, JUNG J H. Effects of computer assisted cognitive rehabilitation on brain wave, memory and attention of stroke patients: a randomized control trial[J]. J Phys Ther Sci, 2015, 27(4):1029-1032.
[28] 魏 淡, 崔永健, 付广印, 等. 早期康复对急性脑梗死患者功能恢复的影响及运动诱发电位对其评定价值[J]. 中华物理医学与康复杂志, 2006, 28(9):605-606.
[29] 赵沂敏, 方定华. 运动诱发电位在脑血管病运动功能康复中的应用[J]. 北京医学, 2002, 24(5):307-309.
[30] 赵利娜, 张志强, 张立新, 等. 1 Hz重复经颅磁刺激对缺血性卒中后上肢运动功能的疗效[J]. 中国康复理论与实践, 2015, 21(2):216-219.
[31] 马 超, 许俭兴. 躯体感觉诱发电位在康复评估中的应用[J]. 现代康复, 2000, 4(11):1692-1693.
[32] 肖 湘, 黄东锋, 曹黎明, 等. 体感诱发电位和卒中患者上肢运动功能结局的关系[J]. 中国康复医学杂志, 2015, 30(7):696-698.
[33] 尹小钢, 潘广伟, 黄瑞瑜, 等. 事件相关电位P300对脑卒中康复期轻度认知损伤的诊断价值[J]. 现代诊断与治疗, 2015, 26(7):1609-1610.
[34] 甘照儒, 王庆武, 刘海兰, 等. 早期康复干预对急性脑梗死患者神经功能及脑血流的影响[J]. 中国康复理论与实践, 2008, 14(12):1163-1164.
[35] 成祥林, 向明清, 熊勋波, 等. 早期康复治疗对脑梗死偏瘫患者脑血流的影响[J]. 中国康复, 2008, 23(5):319-320.
[36] 戴慧寒, 高庆春, 黄如训. 大脑中动脉血流变化在脑卒中运动功能康复预测中的价值[J]. 中华物理医学与康复杂志, 2004, 26(8):476-479.
