MEASURMENT OF THE MUSCLE TENSION IN ELECTROMYOGRAPHICAL EXAMINATIONS AFTER INTRATHECAL BACLOFEN ADMINISTRATION IN PATIENTS WITH SYMPTOMS OF CELEBRAL PALSY AND AFTER CRANIO-CEREBRAL TRAUMA
Journal Title: Issues of Rehabilitation, Orthopaedics, Neurophysiology and Sport Promotion-IRONS - Year 2014, Vol 7, Issue 7
Abstract
Introduction. Increased muscle tension in children with cerebral palsy or in patients with traumatic brain injuries in clinical conditions is usually evaluated with Ashworth’s scale, burdened with subjectivity of both the patients and physician. During the muscle’s resting state, the reference amplitude value in sEMG recording (surface electromyography) corresponding to the proper muscle tension is 20-25 µV. During the muscle’s effort (the test of maximum contraction lasting 5 seconds) sEMG amplitude parameter increases while the amplitude determining hypertonia recorded under resting conditions decreases. Aim. The aim of the study was to verify the action of intrathecal baclofen administration to changes in the function of muscle’s motor units during maximal contraction and relaxation in patients withsymptoms of cerebral palsy and after cerebro-cranial trauma. Material and methods. The pilot studies were performed in 8 patients with spastic paralysis of thelower extremities, children with cerebral palsy and patients after cranio-cerebral trauma. Using the surface electromyography, activity of motor units in lower extremities muscles at rest and contraction was assessed on both sides. sEMG recordings were analyzed three times, before one and twice after intrathecal baclofen administration into the subarachnoid space via an infusion pump. Results. In the group of patients there was found an improvement in the activity of motor units in gastrocnemius muscles bilaterally and biceps femoris muscles during the maximal contraction recorded 15 minutes after the administration of baclofen. Even better recording of sEMG amplitude parameters were obtained after 2 hours. sEMG amplitude measurements under resting conditions indicate for a delayed in time phenomenon of muscle tension decreasing after administration of baclofen. Conclusions. sEMG results confirm the possibility of precise observation of changes in muscle tension in the course of cerebral palsy or following cranio-cerebral traumas. Results of research indicate that increasing in the efficiency of the tested muscle motor units takes place only while the muscle tension is reduced. The efficacy of treatment with baclofen does not depend on the etiology of the disease.
Authors and Affiliations
Aleksandra Kulczyk, Joanna Lipiec, Oksana Leśków, Juliusz Huber, Agnieszka Wincek, Maciej Idzior, Marek Jóźwiak
Keywords
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