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KMID : 0350519920450031127
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Journal of Catholic Medical College
1992 Volume.45 No. 3 p.1127 ~ p.1139
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The Reliability of F wave for Spasticity Evaluation in the Stroke Hemiplegic Arms
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Abstract
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The reliability of F wave parameters such as F amplitude(absolute, F20 and F%/M, F20/M) and F persistency was evaluated in fifty five patients with unilateral spastic hemiplegia caused by stroke and in forty normal subjects. A series of 20
supramaximal
stimuli at 0.5Hz were applied on both median and ulnar nerves in normal subjects' arms(normal group), in unaffected arms(control group) and in affected arms(experimental group) of patients. The results were interpreted with modified Ashworth
scale
and
Brunnstrom stage in order to determine whether F wave changes were reliable or not in spasticity and whether those were correlated with the two clinical grading methods.
@ES The results were as follows:
@EN 1. The amplitudes of M wave in normal, control and experimental groups were not significantly different.
2. In normal group, the values of F20 were 384.64*117.45uV(median nerve), 317.11*101.15uV(ulnar nerve) and in control group, 401.40*137.93uV, 318.17*129.46uV, respectively, Those of experimental group were 452.20*290.61uV and 365.53*214.84uV
respectively, which were not significantly different from the other groups.
3. In normal group, the values of F20/M were 2.85*1.37%(median nerve), 2.05*0.54%(ulnar nerve) and in control group, 3.05*1.85, 2.37*0.98%, respectively. Those of experimental group were 6.76*8.68% and 4.72*4.39% respectively, which showed
statistically significant increase(P<0.01).
4. In normal group, the values of F persistency were 71.16*16.24%(median nerve), 70.85*14.03%(ulnar nerve) and in control group 75.09*11.53%, 76.59*10.88%, respectively. Those of experimental group were 86.54*10.81% and 86.02*8.28% respectively,
which
showed statistically significant increase(P<0.05).
5. In experimental group, the modified Ashworth scale and F20/M of both median and ulnar nerves showed significantly positive correlation relationship(Spearman correlation coefficient r=0.93 for median nerve, r=0.86 for ulnar nerve, P<0.001).
For
median nerve, the values of F20/M were 1.59*0.66%(scale 1), 3.75*0.79%(scale 1+), 5.03*1.10%(scale 2), 7.85*2.17%(scale 3) and 24.81*19.41%(scale 4) and for ulnar nerve, those were 1.94*0.53%, 2.96*0.53%, 3.36*0.77%, 5.75*0.72% and 14.92*7.20%
respectively, which showed significant difference even among the scales.
6. In experimental group, the Brunnstrom stage and F persistency showed significantly positive correlation relationship. For median nerve, the values of F persistency were 70.79*10.21%(stage 2), 88.60*5.64%(stage 3), 85.01*7.08%(stage 4),
93.04*5.65%(stage5) and 93.58*3.76%(stage 6)(r=0.71, P<0.001), For ulnar nerve, those were 76.70*5.24%, 82.11*4.90%, 87.47*3.53%, 92.01*2.74% and 95.01*4.07%, respectively(r=0.88, P<0.001).
Based on the results, F amplitude(F20/M rather than F20) and F persistency were considered to be more easier and reliable indicators for assessing and grading clinical spasticity.
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