新型肌肉定量评估仪评估神经根型颈椎病患者两侧肩颈肌肉的性能失衡  

Imbalance of mechanical properties about bilateral shoulder and neck muscle in patients with cervical spondylotic radiculopathy using MyotonPRO

作　　者：陈伟健[1] 陈泽华 吴佳涛 许学猛[1,2] 杜建平[2] Chen Weijian;Chen Zehua;Wu Jiatao;Xu Xuemeng;Du Jianping(Fifth School of Clinical Medicine,Guangzhou University of Chinese Medicine,Guangzhou 510405,Guangdong Province,China;Guangdong Second Traditional Chinese Medicine Hospital,Guangzhou 510095,Guangdong Province,China)

机构地区：[1]广州中医药大学第五临床医学院,广东省广州市510405 [2]广东省第二中医院,广东省广州市510095

出　　处：《中国组织工程研究》2022年第3期430-434,共5页Chinese Journal of Tissue Engineering Research

基　　金：广东省科技计划项目(2019A141401008,2021B1111610007),项目负责人:许学猛;广东省软科学研究计划项目(2018B020207009),项目负责人:许学猛;广东省基础与应用基础研究基金项目(2021A1515011545),项目负责人:许学猛。

摘　　要：背景:研究发现神经根型颈椎病的肩颈部肌肉力学性能会发生改变,且与症状程度相关。目的:利用新型肌肉定量评估仪MyotonPRO测量并对比分析神经根型颈椎病患者和正常人上斜方肌及胸锁乳突肌的肌肉性能,探讨神经根型颈椎病患者肩颈肌肉失衡现象的原因,为该病的防治及康复锻炼提供依据。方法:选择25例神经根型颈椎病患者及基线资料匹配的25例正常人,采用MyotonPRO定点测量胸锁乳突肌及上斜方肌的张力、刚度并进行对比,通过计算不对称指数来比较神经根型颈椎病患者与正常人的肌肉性能失衡情况,并收集神经根型颈椎病患者的目测类比评分、Northwick Park颈痛量表评分进行相关分析。结果与结论:(1)神经根型颈椎病患者的两侧上斜方肌及胸锁乳突肌张力、刚度的平均值均大于正常人,且神经根型颈椎病患者的患侧上斜方肌张力、刚度高于对侧,差异均有显著性意义(P<0.05);(2)神经根型颈椎病患者的上斜方肌及胸锁乳突肌的张力、刚度的不对称指数与正常人相比,差异均有显著性意义(P<0.05),说明神经根型颈椎病患者的肌张力、刚度均高于正常人组;(3)神经根型颈椎病患者的目测类比评分与Northwick Park颈痛量表评分均与上斜方肌的张力、刚度均呈显著正相关(P<0.05);(4)提示神经根型颈椎病患者因为局部软组织炎症、疼痛、姿势等影响,通常表现出上斜方肌及胸锁乳突肌的张力和刚度升高,并且左右两侧的张力和刚度存在明显的失衡情况,这种肌肉力学性能的改变与疼痛及生活质量表现出正相关关系;故在神经根型颈椎病的防治中,需要关注肌肉的张力、刚度失衡,纠正失衡。BACKGROUND:Studies had shown that the mechanical properties of the shoulder and neck muscles in cervical spondylotic radiculopathy are altered and correlated with the degree of symptoms.OBJECTIVE:To compare the mechanical properties of upper trapezius and sternocleidomastoid muscle in cervical spondylotic radiculopathy patients by MyotonPRO,and to explore the causes of shoulder and neck muscle imbalance in cervical spondylotic radiculopathy patients so as to provide a basis for the prevention and treatment of the disease and rehabilitation exercises.METHODS:Totally 25 patients with cervical spondylotic radiculopathy and 25 normal people matched with baseline data were selected.MyotonPRO was used to measure the tension and hardness of sternocleidomastoid muscle and superior trapulus muscle for comparison.The muscle performance imbalance of cervical spondylotic radiculopathy patients and normal people was compared by calculating the asymmetry index.Visual analogue scale score and Northwick Park Neck Pain Questionnaire scores of cervical spondylotic radiculopathy patients were collected for correlation analysis.RESULTS AND CONCLUSION:(1)The mean values of upper trapezius and sternocleidomastoid muscle tension and stiffness on both sides of cervical spondylotic radiculopathy group were higher than those of the healthy group.The upper trapezius tension and stiffness of the affected side were higher than those of the contralateral side in the cervical spondylotic radiculopathy group,and the differences were statistically significant(all P<0.05).(2)The upper trapezius and sternocleidomastoid muscle tension and stiffness asymmetry indexes in cervical spondylotic radiculopathy group were significantly different from those in the healthy group(all P<0.05).These indicated that the muscle tension and stiffness in the cervical spondylotic radiculopathy group were higher than those in the normal group.(3)Visual analogue scale score and Northwick Park Neck Pain Questionnaire score were significantly positively correlated with u

关 键 词：神经根型颈椎病 胸锁乳突肌 上斜方肌 刚度 张力 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学]