基于数字化弹性触诊仪分析下肢体位对小腿三头肌硬度的影响  

Influence of lower limb position on triceps surae muscle stiffness:A digital palpation device based analysis

作　　者：张瑾[1] 张顺喜[1] 彭源[1] 郑嘉璇 袁联雄 华学锋 兰月[1] Zhang Jin;Zhang Shunxi;Peng Yuan;Zheng Jiaxuan;Yuan Lianxiong;Hua Xuefeng;Lan Yue(Department of Rehabilitation Medicine,Guangzhou First People’s Hospital,Guangzhou 510180,China;Department of Rehabilitation Medicine,Shantou Central Hospital,Shanton,Guangdong 515000,China;Department of Science,Education and Information,Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510180,China;Second Department of Hepatobiliary Surgery,Guangzhou First People’s Hospital,Guangzhou 510180,China)

机构地区：[1]广州市第一人民医院康复医学科,广东广州510180 [2]汕头市中心医院康复医学科,广东汕头515000 [3]中山大学附属第三医院科教信息科,广东广州510180 [4]广州市第一人民医院肝胆外科二科,广东广州510180

出　　处：《广州医科大学学报》2020年第5期1-8,共8页Academic Journal of Guangzhou Medical University

基　　金：国家自然基金面上项目(181772428,81974357);广州市科技计划项目(201803010083)。

摘　　要：目的:基于数字化弹性触诊仪分析下肢体位对小腿三头肌硬度的影响。方法:在俯卧位、站立位、踮足位三种体位下,应用数字化弹性触诊仪MyotonPRO对2018年6月-12月间于广州市第一人民医院康复医学科筛选25位健康志愿者右下肢比目鱼肌、腓肠肌内侧头及外侧头的硬度进行测量。采用线性混合效应模型分析不同体位对小腿三头肌硬度的影响,同时分析年龄、性别、体重指数对小腿三头肌硬度的影响。结果:只考虑体位对肌肉硬度的影响,提示不同体位下的肌肉硬度差异有统计学意义(P<0.05)。以踮足位肌肉硬度为参照组,其它两种体位与踮足位相比,差异均有统计学意义(P<0.05),参考偏回归系数可知小腿三头肌的硬度俯卧位<站立位<踮足位。进一步考虑年龄、性别、体重指数的影响,体位仍然是影响小腿三头肌硬度的独立影响因素(P<0.05)。以踮足位肌肉硬度为参照组,其它两种体位与踮足位相比,差异均有统计学意义(P<0.05),参考偏回归系数,小腿三头肌的硬度俯卧位<站立位<踮足位。年龄、性别和体重指数对比目鱼肌硬度无影响,性别对腓肠肌内侧头及外侧头肌肉硬度有影响(P<0.05,偏回归系数分别为-157.75、-122.77),女性腓肠肌内外侧头肌肉硬度低于男性(P<0.05)。结论:下肢体位对健康人群小腿三头肌的硬度有影响。同时性别对腓肠肌内侧头及外侧头的硬度有影响,女性肌肉硬度低于男性,而年龄和体重指数对该肌肉硬度影响不大。数字化弹性触诊仪MyotonPRO可有效区分不同体位下及不同性别小腿三头肌的肌肉硬度,因此临床检查小腿三头肌时,要考虑到体位、性别带来的个体差异。Objective:To investigate the influence of lower limb position on triceps surae muscle stiffness based on analysis with Myoton PRO,a digital palpation device.Methods:In prone,standing,and tiptoe positions,Myoton PRO was used to measured the muscle stiffness of soleus muscle,medial and lateral heads of gastrocnemius of the lower limb in 25 healthy volunteers recruited from Department of Rehabilitation Medicine,Guangzhou First People’s Hospital,between June and December,2018.Linear mixed-effect model was used to analyze the influence of different body positions,as well as the effects of age,gender,and body mass index,on triceps surae muscle stiffness.Results:As far as the influence of body positions alone on muscle stiffness was considered,the muscle stiffness varied significantly with different body positions(P<0.05).With the value in tiptoe position as the reference,the muscle stiffness in the other two positions was statistically different(P<0.05).Based on the partial regression coefficients,the triceps surae muscle stiffness was smallest in prone position,followed by those in standing position and tiptoe position,from low to high.Taken into consideration the effects of age,gender,and body mass index,body position remained to be an independent factor affecting the stiffness of triceps surae muscle(P<0.05).With the value in tiptoe position as the reference,the muscle stiffness in the other two positions was statistically different(P<0.05).Based on the partial regression coefficients,the triceps surae muscle stiffness was smallest in prone position,followed by those in standing position and tiptoe position,from low to high.Age,gender and body mass index did not interfere with the stiffness of soleus muscle,but that gender had an effect on muscle stiffness of the medial and lateral heads of the gastrocnemius(P<0.05;partial regression coefficients:-157.75 and-122.77,respectively).Females had lower muscle stiffness of medial and lateral heads of the gastrocnemius compared with males(P<0.05).Conclusion:The body posit

关 键 词：体位 小腿三头肌 硬度 影响因素 

分 类 号：R496[医药卫生—康复医学]