Correlation between co-contraction of lower limb muscles and limb function in stroke patients with hemiplegia during the stance phase of gait

doi:10.3877/cma.j.issn.2095-123X.2025.01.004

Abstract

Abstract:

Objective

To explore the correlation between the co-contraction rate （CCR） of lower limb muscles during the stance phase in stroke hemiplegic patients and the limb function.

Methods

From September 2017 to October 2024， a total of 55 stroke hemiplegic patients admitted to the Rehabilitation Medicine Department of Hefei Second People's Hospital were iretrospectively analyzed. The CCR of rectus femoris （RF） and biceps femoris （BF） of the lower limb was computed in 55 stroke hemiplegic patients using surface electromyography between the initial foot strike and the peak of knee extension during the stance phase based on three-dimensional kinematic analysis. The Fugl-Meyer lower limb motor assessment （FMA）and Brunnstrom staging （BRS） were used to evaluate the lower limb function， and the modified Ashworth scale （MAS） was used to evaluate the muscle tone of hemiplegic lower limb； The correlation between CCR and FMA， BRS， MAS were analyzed.

Results

Among the patients in this group， there were 10 cases in stage BRS Ⅲ， 24 cases in stage Ⅳ， 19 cases in stage Ⅴ， and 2 cases in stage Ⅵ. The CCR of the involved extremity （1.077±0.369） was significantly higher than that of the uninvolved extremities （0.760±0.334）（P＜0.05）. A positive correlation between CCR and MAS （r=0.347， P＜0.05）， and negative correlation between CCR and BRS （r=-0.913， P＜0.05） or FMA （r=-0.916， P＜0.05） were observed during the stance phase of gait in hemiplegic stroke patients.

Conclusion

CCR can quantitatively evaluate the lower limb function status and spasm degree of patients with stroke hemiplegia， and can be used in clinical evaluation of the limb function of patients with stroke hemiplegia.

Key words: Stroke, Hemiplegia, Muscle co-contraction rate, Lower limb function, Muscle tone

Pingping Ge, Xiaoguang Cao, Luping Chen, Hai Yuan. Correlation between co-contraction of lower limb muscles and limb function in stroke patients with hemiplegia during the stance phase of gait[J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2025, 15(01): 21-25.

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Figures/Tables 4

Fig.1 Electromyogram signals of the biceps femoris and rectus femoris during the initial foot strike of the stance phase

Fig.2 Electromyogram signals of the biceps femoris and rectus femoris during the peak of knee extension of the stance phase

Tab.1 Distribution of CCR and FMA in different stages of Brunnstrom （Mean±SD）

Brunnstrom分期	例数	FMA（分）	CCR
Ⅲ期	10	18.000±1.563	1.649±0.327
Ⅳ期	24	26.417±1.640	1.127±0.094
Ⅴ期	19	30.526±1.020	0.768±0.163

Tab.2 Correlation analysis of CCR with MAS， BRS， and FMA

指标	r 值	P 值
MAS	0.347	0.007
BRS	-0.913	＜0.001
FMA	-0.916	＜0.001

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