The Research of the sEMG on Early Diagnosis and Rehabilitation Effect Assessment of Children with Spastic Cerebral Palsy
|School||Anhui Medical University,|
|Keywords||cerebral palsy (CP) motor function clinical spasticity index (CSI) Inter-pulse Interval (IPI) Correlation regression analysis|
Objective To investigate the early diagnosis and rehabilitation effect assessment valueof sEMG inter-pulse Interval (IPI) of Motor Unit Action Potential in children withspastic cerebral palsy.Methods1. Clinical data of64children in the age range of9to160months withspastic cerebral palsy were collected; Motor function and spasticity of these childrenwere assessed by Chinese version of the Gross Motor Function Measurement-88(GMFM-88), Chinese version of the Gross Motor Function Classification System(GMFCS) and clinical spasticity index (CSI). Simultaneously, Surface Electromyogram(sEMG) was collected from their legs through surface electromyography technologycombining mechanical accelerometer.The Inter-pulse Interval (IPI) of MUAP werecalculated through Smoothed Nonlinear Energy Operator algorithm and three gradefilter technology application that are pre-established based on empirical modedecomposition (EMD by research group.Statistical correlation analysis were applied toexamine the multivariate association between the five explanatory variables (gender,age, GMFM-88total scores, GMFCS classification results and spasticity) and theircorresponding IPI.2. To explore the factors that affecting the Inter-pulse Interval(IPI) of the motor unitaction potential（MUAP) through the correlation analysis, then, suitable regressionmodel parameters was Established by regression statistical processing so as to lay thefoundation research for quantifing the evaluation indicator of Inter-pulse Interval(IPI). 3. Reference to the gender and month of experimental group children for the baseline,64normal children were selected as the control group, The Inter-pulse Interval (IPI) ofMUAP were calculated by the technology of surface electromyography, then the twosets of data were matched through t-test comparative analysis.4.20cases of perinatal brain injured infants were selected as the predictiveexperimental group,20normal newborns as the control group, the surfaceelectromyography assessments in the general movements were applied in foot-monthage of four weeks, eight weeks and16weeks respectively.The cerebral imagingexaminations were taking in the predictive experimental infants within the corrective3-month-old,Then follow-up to12months of age,the number of children with the cleardiagnoses of cerebral palsy was sumed up.And the average of the MUAP of the IPIwas calculated. At last,to analyze surface electrical characteristics in generalmovements and the applied value of IPI in children with cerebral palsy.Results1. The correlation of IPI with GMFCS classification, spasm subtypes,spasticityindex and spasticity showed positive (rsis0.903,0.527,0.663,0.499in respectively, P<0.001), but correlation between the IPI and GMFM-88total score was negative (Rs=0.738, P <0.001). At same time, correlation with age and sex had no significant (P>0.05).2.Regression equation=6.019+1.011X1-0.66X（2=The Inter-pulse Interval X1=clinicalspasticity index,X2=GMFM-88total scores), R2=0.642.3. The difference between the IPI of experimental group and the control group wassignificant (P <0.05). 4. Within20infants of perinatal brain injured,16patients were dignosed with cerebralpalsy after the follow up; There was no significant difference between the IPI ofpredictive experimental group and the control group (P>0.05).Conclusion1. The Inter-pulse Interval (IPI) of MUAP had significant correlationswith the spasticity and motor function in children with spastic cerebral palsy, which canbe used as a comprehensive and quantitative assessment index for children with spasticcerebral palsy.2. It have some predictive value of the surface electromyography techniques in generalmovement assessments for perinatal brain injured infants, but the IPI of the motor unitaction potential (MUAP) has not been yet become an effective early assessmentindicator for cerebral palsy.