脑瘫尖足患儿站立和行走中下肢肌肉的表面肌电图  

Surface electromyogram features of the lower limb muscles in cerebral palsy children standing and walking on tiptoes

作　　者：许萍 梁雷超 梁贞文 蔡明[1] 陈博[2] 黄萍[2] 张琳琳[1] Xu Ping;Liang Leichao;Liang Zhenwen;Cai Ming;Chen Bo;Huang Ping;Zhang Linlin(Shanghai University of Medicine and Health Sciences,Shanghai 201318,China;Shanghai Institute of Traumatology and Orthopaedics,Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases with Integrated Chinese-Western Medicine,Shanghai Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China)

机构地区：[1]上海健康医学院,上海市201318 [2]上海市伤骨科研究所,上海市中西医结合防治骨与关节病损重点实验室,上海交通大学医学院附属瑞金医院,上海市200025

出　　处：《中国组织工程研究》2020年第23期3673-3677,共5页Chinese Journal of Tissue Engineering Research

基　　金：上海市卫生和计划生育委员会科研课题(面上:201640190),项目负责人:黄萍;上海市卫生和计划生育委员会中医药科研课题(2018JP008),项目负责人:黄萍。

摘　　要：背景:在控制良好的情况下,肌电信号活动的变化在很大程度上能够定量反映肌肉功能状态、肌张力、肌力水平、多肌群协调性等肌肉的变化,对肌肉功能状况提供客观指标。目的:探讨脑瘫尖足患儿站立和行走中下肢肌肉的表面肌电图变化。方法:应用美国NORAXON公司生产的TELEMYO 2400R G2表面肌电图遥测仪对20例脑瘫单侧尖足患儿在静止站立、常态行走下进行双下肢胫前肌、腓肠肌内侧的表面肌电测试。比较受试者尖足侧与对侧肌肉的肌电活动。研究方案经过了上海瑞金医院伦理委员会批准,所有受试者及监护人均签署了“知情同意书”。结果与结论:①受试者静止站立和常态行走时,其尖足侧腓肠肌内侧的平均肌电振幅、平均肌电积分均低于对侧(P<0.05);②受试者静止站立和常态行走时,其尖足侧胫前肌和腓肠肌内侧的平均频率、中位频率均高于对侧(P<0.05);③结果说明,脑瘫患儿尖足侧胫前肌、腓肠肌内侧存在表面肌电图信号异常,脑瘫单侧尖足患儿下肢肌肉活动不均衡,提示表面肌电图对脑瘫患儿神经肌肉系统功能状态的评价具有实用价值。BACKGROUND:Under well-controlled conditions,changes in myoelectric signal activity can largely reflect muscle changes such as muscle function,muscle tension,muscle strength,and multi-muscle coordination,providing objective analysis of the muscle function.OBJECTIVE:To investigate the changes in surface electromyography(SEMG)of the lower limb muscles in cerebral palsy children standing or walking on tiptoes.METHODS:Using TELEMYO 2400R G2 SEMG telemeter produced by NORAXON Company in the United States,surface EMG features of bilateral anterior tibial muscles and medial gastrocnemius muscles were detected in 20 cerebral palsy children standing or walking on unilateral tiptoes.The myoelectric activity of the testicular muscles between the pointed and contralateral side was compared in all the subjects.The study protocol was approved by the Ethics Committee of Shanghai Ruijin Hospital,and all subjects and their guardians signed an informed consent prior to the participation in the study.RESULTS AND CONCLUSION:When the subjects were standing and walking normally,the average SEMG amplitude and average SEMG integral of the medial gastrocnemius at the tiptoe side were significantly lower than those at the contralateral side(P<0.05);the mean and median frequencies of the anterior tibial muscles and medial gastrocnemius muscles at the tiptoe side were significantly higher than those at the contralateral side(P<0.05).These findings indicate that there are abnormal SEMG signals in the anterior tibial muscles and medial gastrocnemius muscles at the tiptoe side in children with cerebral palsy,and the muscle activity of the lower limbs in such children is not balanced.Therefore,SEMG is of practical value in evaluating the functional status of the neuromuscular system in children with cerebral palsy.

关 键 词：脑瘫 尖足 表面肌电图 胫前肌 腓肠肌 康复 

分 类 号：R445[医药卫生—影像医学与核医学] R496[医药卫生—诊断学]