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Rehabilitation Practice and Science

Translated Title

以定量肌電圖評估痙攣上肢注射肉毒桿菌毒素後之療效—初步研究報告

Abstract

Spasticity of the upper limb muscles is a common complication following stroke. Injection of botulinum toxin can decrease upper limb spasticity. The effects of botulinum toxin treatment are usually evaluated by activities of daily living, range of motion (ROM), or modified Ashworth scale. However, in this study, we evaluated the effect of botulinum toxin injection by quantitative EMG, and investigated the relationship between EMG and conventional evaluation methods.Twenty patients with chronic stroke-related spasticity of the upper limb muscles received botulinum injections. All injections were guided by EMG. Outcome measures included total modified Ashworth scale score on the elbow, wrist, metacarpal joints, proximal interphalangeal joints, and the distal interphalangeal joints of the affected side; fast and slow ROM, and Brunnstrom stages (including proximal and distal). Parameters of EMG turns-amplitude analysis were also recorded. The above parameters were re-evaluated at 4 and 12 weeks following the initial injection. After 4 and 12 weeks of botulinum toxin treatment, average resting amplitudes, voluntary maximal contraction amplitudes, number of turns per second, and modified Ashworth scale scores all significantly decreased. The fast and slow elbow and wrist joint movements were significantly improved after 4 weeks of injection. However, only a minimal effect was noted during week 12. The fast and slow range of motion of interphalangeal and metacarpal joints showed only marginal improvements after 4 and 12 weeks of treatment. No significant alterations in the limb movement pattern were observed by Brunnstrom stages. The correlation coefficient of conventional assessment and EMG analysis data was greater than 0.7, which indicated a significant correlation. In conclusion, quantitative EMG is a suitable tool for evaluating the effect of botulinum toxin treatment in patients with stroke-related chronic spasticity in the upper limbs. EMG was highly correlated with the conventional assessment methods.

Language

Traditional Chinese

First Page

195

Last Page

201

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