静力牵伸与等长收缩对颈肩肌肉疼痛患者上斜方肌肌电图特征性变化及疼痛指数的影响  

The changes of EMG characteristic and VAS index for the patients' upper trapezius with neck-shoulder complaints after stretching and isometric-contraction training

作　　者：牛岩[1,2] 黄力平[2] 曹龙军[2] 邢剑[2,3] 田强[2] 刘畅格[2] 周石[2] 

机构地区：[1]天津市儿童医院康复科,天津300371 [2]天津体育学院健康与运动科学系 [3]北京大学第三临床医院康复医学科

出　　处：《中国康复医学杂志》2016年第4期411-416,共6页Chinese Journal of Rehabilitation Medicine

基　　金：天津市高等学校创新团队培养计划(TD12-5056);国家科技支撑计划项目(2012BAK21B00)

摘　　要：目的:通过对颈肩疼痛受试者的上斜方肌静力牵伸、等长收缩以及静力牵伸加等长收缩,观察其肌电图特征性变化以及主观疼痛感觉变化,探索不同干预缓解肌肉疼痛、降低肌肉紧张的最低重复次数和时间,比较三种方法的优劣,以确定最小有效干预剂量和较佳干预方案。方法:招募20例颈肩疼痛受试者,随机抽取12例为一组,共抽取3次,分别对上斜方肌进行静力牵伸、等长收缩以及静力牵伸加等长收缩干预,每组干预时间间隔15d,对上斜方肌进行肌电图检测和干预前后的疼痛视觉模拟量表(VAS)衡量主观疼痛感觉。结果:静力牵伸、等长收缩以及静力牵伸加等长收缩干预后,颈肩部主观疼痛感显著降低(P<0.01、P<0.05和P<0.01);静力牵伸和静力牵伸加等长收缩干预后,右侧上斜方肌表面肌电图(s EMG)静息绝对值和相对值有显著降低(P<0.01);等长收缩干预后右侧上斜方肌s EMG静息绝对值和相对值无显著性差异(P>0.05);静力牵伸加等长收缩和静力牵伸比等长收缩干预更能有效的降低右侧上斜方肌s EMG静息绝对值和相对值(P<0.05)。结论:三种运动干预方案均能起到缓解受试者颈肩部疼痛的即时效果,静力牵伸和静力牵伸加等长收缩能够有效的缓解颈肩部疼痛患者肌紧张。Objective： To detect the changes of EMG characteristic and VAS index for the patients＇ upper trapezius with neck-shoulder complaints after stretching and isometric-contraction training. To identify the the minimum effective dose and the best intervention by detecting and comparing the minimum repeated times and time of three methods alleviating muscle pain and reducing muscle tension.Method： We recruited twenty patients with neck-shoulder complaints, from whom 12 subjects were randomly selected for 3 times. The upper trapezius for each patient was given stretching, isometric contraction and stretching-isometric contraction training, respectively, with 15 days interval. Before and after intervention, EMG examination and VAS test were performed.Result： After the intervention, VAS index decreased significantly（P〈0.01, P〈0.05 and P〈0.01）. In the right side of the upper trapezius, the resting absolute value and relative value of s EMG were decreased significantly（P〈0.01） after stretching or stretching-isometric contraction, while no significant difference after isometric contraction（P〈0.05）. As a result, stretching and stretching-isometric contraction were more effective to decrease the resting absolute value and relative value of s EMG in the right side of the upper trapezius muscle compared with isometric contraction（P〈0.05）.Conclusion： All of the three exercise interventions can alleviate the neck- shoulder complaints. At the same time, the stretching and stretching- isometric contraction intervention were more effective to alleviate the pain and reduce the muscle tension.

关 键 词：颈肩痛 静力牵伸 等长收缩 肌电图 

分 类 号：R687.3[医药卫生—骨科学]