| 陈 煜,管红波,黄桂兰,苏 彬,梁成盼,贾澄杰.偏瘫肩痛患者肩胛肌肉的表面肌电特征研究[J].中国康复医学杂志,2020,(4):447~452 |
| 偏瘫肩痛患者肩胛肌肉的表面肌电特征研究 点此下载全文 |
| 陈 煜 管红波 黄桂兰 苏 彬 梁成盼 贾澄杰 |
| 无锡市同仁康复医院康复治疗部，江苏省无锡市，214151 |
| 基金项目：无锡市卫生计生委青年项目（Q201635）；无锡市卫生健康委面上项目（MS201754） |
| DOI：10.3969/j.issn.1001-1242.2020.04.011 |
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| 摘要： |
| 摘要
目的：应用表面肌电技术探讨偏瘫肩痛患者在上肢特定功能动作中肩胛肌肉的表面肌电特征。
方法：选取2019年1月至2019年6月在无锡市同仁康复医院住院的脑卒中后偏瘫肩痛者21例作为偏瘫肩痛试验组（HSP组）；年龄、性别以及其他因素与HSP组相匹配的健康志愿者22例为健康对照组。应用表面肌电技术记录HSP组患侧和对照组利手侧上斜方肌（upper trapezius， UT）、中斜方肌（middle trapezius， MT）、下斜方肌（lower trapezius， LT）和前锯肌（serratus anterior， SA）在最大等长收缩（MVIC）以及“够物”动作中的表面肌电信号，原始信号经处理后对比分析肌电特征，包括目标肌肉激活水平（MVIC%）和激活比率（UT/LT、UT/SA、MT/SA）。
结果：①比较“够物”动作过程中各目标肌肉激活水平：HSP组UT激活水平（MVIC%）大于健康对照组，具有显著差异（P＜0.01）；SA和LT激活水平明显小于对照组（P＜0.01）；两组之间MT的MVIC%值无显著性差异（P＞0.05）。②各目标肌肉的在“够物”过程中UT/LT、UT/SA、MT/SA激活比率情况对比：HSP组的 UT/LT、UT/SA、MT/SA 的激活比率均高于健康对照组（P＜0.05）。
结论：偏瘫肩痛患者在够物过程中表面肌电存在异常特征性改变。在运动学上，表面肌电用于评估该类患者肩胛骨的运动具有相当可行性，可定量评估其运动功能障碍并为临床康复治疗提供客观指导。 |
| 关键词：脑卒中 偏瘫肩痛 肩胛骨 表面肌电 |
| A study on surface EMG characteristics of scapular muscles as shoulder anteflexion in patients with hemiplegic shoulder pain Download Fulltext |
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| Wuxi Tongren Rehabilitation Hospital， 158 Qianrong Road， Binhu District， Wuxi City， Jiangsu Province， China， 214151 |
| Fund Project: |
| Abstract: |
| Abstract
Objective: Applying surface electromyography to investigate the sEMG characteristics of scapular muscles as shoulder flexion in patients with hemiplegia shoulder pain.
Method： Twenty-one post-stroke patients with hemiplegic shoulder pain admitted in Wuxi Tongren Rehabilitation Hospital between January and June of 2019 were selected as the experimental group，or HSP group. Control group was composed of twenty-two healthy volunteers whose age， sex and other factors were matched with those of experimental group. During maximum voluntary isometric (MVIC) flexing the shoulder to reaching an object, surface electromyograms (sEMGs) were recorded synchronously from Upper Trapezius (UT)， Middle Trapezius (MT)， Lower Trapezius (LT) and Serratus Anterior (SA) and compared those from affected sides of experimental subjects with dominant sides of control individuals， MVIC% and activation ratio (UT/LT， UT/SA， MT/SA) were analyzed and compared those between two groups.
Result： The activation level of the UT in the HSP group was significantly higher than that in the control group (P＜0.01)， while the activation levels of the LT and SA were significantly lower (P＜0.01). There was no statistically significant difference (P>0.05) in the MT activation level between two groups. Moreover， in terms of activation ratios of the target muscles (UT/LT， UT/SA， MT/SA) in the reaching movement， UT/LT， UT/SA and MT/SA of the HSP group were larger than those of the control group (P<0.05).
Conclusion： There are abnormal characteristic changes in sEMG in patients with HSP during the reaching movement. Kinematically， sEMG is quite feasible for assessing the scapular movement in this kind of patients. This quantitative assessment approach for motor dysfunction can provide objective guidance on clinical rehabilitation. |
| Keywords:stroke hemiplegic shoulder pain scapular surface EMG |
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