工作相关颈肩肌肉骨骼疾患表面肌电信号的特征研究  

A research on revealing the Surface electromyograph signal feature of work-related neck shoulder musculoskeletal disorders

作　　者：张非若[1] 王生[1] 何丽华[1] 黄燕娣[2] 张颖[3] 胡广义[1] 叶康平[1] 

机构地区：[1]北京大学公共卫生学院,北京100191 [2]北京市劳动保护科学研究所,北京100054 [3]北京市大兴区卫生监督所,北京102600

出　　处：《工业卫生与职业病》2013年第2期65-70,共6页Industrial Health and Occupational Diseases

基　　金："十一五"国家科技支撑计划项目资助(2006BAI06B08)

摘　　要：目的使用表面肌电图技术(sEMG)揭示工作相关颈肩肌肉骨骼疾患的sEMG信号特征,为工作相关颈肩肌肉骨骼疾患的诊断和预防提供定量的sEMG信号信息。方法通过Nordic肌肉骨骼疾患问卷将24名缝纫机操作女工分为症状组和无症状组。作业前分别测量每位受试者双侧颈伸肌(CES)和双侧斜方肌上支(UT)的参考自主收缩动作(RVC)的肌电信号并监测连续作业20时段(每10min为1时段)的肌电信号。对原始肌电信号进行低波数字滤波处理后,进行线性计算分析。结果两组双侧CES的%RVE值均随作业时间延长而增大,症状组双侧CES的回归系数和截距均高于无症状组;频谱中位频率(MF)趋势分析显示双侧CES的MF值随作业时间延长而下降,无症状组CES的回归系数和截距均高于症状组,差异有统计学意义(P<0.01);无症状组双侧UT和症状组左侧斜方肌上支(LUT)随作业时间延长呈MF值下降的线性相关,两组LUT比较,差异有统计学意义(P<0.01),症状组右侧斜方肌上支(RUT)与作业时间不呈线性变化;经频谱振幅联合分析(JASA)显示无症状组双侧CES和UT在JASA图中分布均匀,症状组双侧CES和UT在JASA图中分布不均,经检验差异有统计学意义(χ2=46.8,P<0.01),在JASA图中第4象限(疲劳象限)点出现频率高。结论颈肩部肌肉易疲劳并随作业时间延长而加重,右侧斜方肌最易疲劳;等长收缩动作中时域和频域指标可以较好地反映肌肉疲劳,并具有一致性;JASA分析方法可以反映肌肉的动态变化,sEMG信号振幅指标与频谱指标交点在JASA图中分布不均可能是颈肩部疾患症状的sEMG表现。Objective To reveal sEMG signal feature of work--related neck shoulder musculoskeletal disorders using sEMG and to provide criteria for their diagnosis and prevention. Methods 24 female sewing machine operators were divided into two groups, i. e. 12 symptomatic operators as the case group and another 12 asymptomatic operators as the control group classified by standardized Nordic Musculoskeletal Disorders Questionnaire. Before their daily operation the sEMG signals of reference volunteer contractions （RVC）of each testing muscles were measured, then when performing daily work, the sEMG signals were monitored and recorded simultaneously. Linear analysis and jointed amplitude and spectrum analyses（JASA） were used to get further information. Results In symptomatic group the intercept value and regression coefficients of bilateral CES were higher than those of the asymptomatic group. CES of the MF values decreased with the extension of working time, intercept and regression coefficients of bilateral CES and LUT in the asymptomatic group were higher than those of the symptomatic group （P〈 0. 01）, the difference between these two groups was significant （P 〈 0.01 ）. The result of JASA analysis showed that thedistribution was equivalent to the asymptomatic group and uneven in the symptomatic group. In the symptomatic group the 2^nd and the 4^th quadrants distribution were morethan those of the 1st and the 3^rd quadrants, the difference was signifieant（χ^2 =46.80,P〈0. 01）. The point in the 4^th quadrant（fatigue quadrant）appeared more frequently. Conclusions Muscles of neek and shoulder will easily get fatigue and feel more serious as working time prolongs. The right trapezius muscle is the most easily to get fatigue. In isometrie contraction amplitude parameter and spectrum parameter may be good indicators of museular fatigue and show better consistency. JASA analysis may reflect dynamic muscular changes. The uneven distribution of EAslope and MFslope intersection in the 4^th quadrant may ind

关 键 词：颈肩痛 缝纫女工 表面肌电图 线性分析 JASA 

分 类 号：R13[医药卫生—劳动卫生]