摘要
目的:探讨慢性非特异性下背痛(CNLBP)患者与健康人进行腰背肌等长收缩时竖脊肌空间活动分布的差异。方法:选取CNLBP患者15例为实验组(34.95±8.73岁),健康人15名为对照组(30.50±7.84岁)。采用Oswestry功能障碍指数(ODI)、疼痛视觉模拟评分(VAS)进行临床评估。采用高密度表面肌电(HDsEMG),记录两组受试者进行1 min改良等长运动负荷试验(BST)时竖脊肌肌电信号,比较两组中位频率斜率(MFs)的差异;比较收缩初期(开始20 s)、收缩中期(中间20 s)和收缩末期(最后20 s)3个不同收缩时段均方根值(RMS)肌电特征图像的重心和分散度,并分析相关肌电指标与临床评估结果的相关性。结果:竖脊肌MFs实验组和对照组组间对比,差异具有统计学意义(P<0.05)。肌电活动重心和分散度,实验组和对照组组间对比,差异均具有统计学意义(P<0.05);不同收缩时段组内对比,差异均具有统计学意义(P<0.05)。重心与ODI、VAS均具有明显正相关性(P<0.05);分散度与ODI、VAS均具有明显负相关性(P<0.05)。结论:竖脊肌等长收缩时,运动变异增加,肌电活动重心向远端移动;慢性非特异性下背痛患者较健康人运动变异减小,向远端移动减少。慢性非特异性下背痛患者通过改变肌肉激活的位置和范围,重新分配肌肉活动完成耐力任务。HDsEMG可以观察肌肉持续收缩时空间活动变化,用于慢性非特异性下背痛患者肌肉功能评估。
Objective To explore the difference in the spatial activity characteristics between patients with chronic nonspecific low back pain(CNLBP)and healthy subjects during isometric lumbar and dorsal contraction of their erector spinae.Methods Fifteen CNLBP patients were selected into an experimental group,while 15 healthy counterparts were chosen into a control group.The Oswestry disability index(ODI)and visual analog scale(VAS)were used to conduct the clinical evaluation.The high density surface electromyography(HDsEMG)was used to record the EMG signals of the erector spinae of both groups in the 1 min modified isometric exercise load test(BST),and the median frequency slope(MFs)was compared between the two groups.The center of gravity and dispersion of EMG feature images were compared according to three different contraction periods:the initial contraction(20 s),the middle contraction(20 s)and the end contraction(20 s).Moreover,the correlation between the relevant EMG indexes and clinical evaluation results was analyzed.Results Significant differences were found in the average MFs of erector spinae.For the centroid and dispersion of electromyographic activities,there were significant differences between the experimental and control group(P<0.05),as well as among different periods of the same group(P<0.05 for both).The centroid was significantly positively correlated with ODI and VAS(P<0.05).The dispersion was significantly negatively correlated with ODI and VAS(P<0.05).Conclusion When the erector spinae contract isometrically,the motor variability increases,and the centroid of electromyographic activity moved to the caudal side.CNLBP patients have less motor variability and less caudal movement than healthy people.CNLBP patients complete endurance tasks by changing the location and range of muscle activation and redistributing muscle activities.HDsEMG can be used to evaluate muscle function in patients with CNLBP by observing changes in the spatial activity during continuous muscle contraction.
作者
李霞
郝增明
王晓东
陈晓军
Li Xia;Hao Zengming;Wang Xiaodong;Chen Xiaojun(The 3rd Clinical Medical College,Zhejiang Chinese Medical University,Hangzhou 310053,China;The College of Education,Zhejiang University,Hangzhou 310028,China)
出处
《中国运动医学杂志》
CAS
CSCD
北大核心
2021年第5期338-343,共6页
Chinese Journal of Sports Medicine
基金
浙江省基础公益研究计划项目(LGF20H170004)
浙江中医药大学科研基金项目(2017ZZ07)。
关键词
高密度表面肌电
时空激活特性
慢性非特异性下背痛
竖脊肌
high density surface EMG
spatio-temporal activation feature
chronic nonspecific low back pain(CNLBP)
erector spinae
