脑卒中偏瘫患者实施双、单桥式运动对相关核心肌群表面肌电活动影响的规律特征  

Regular characteristics of the effects of double-bridge and single-bridge exercises on the surface EMG activity of related core muscles in stroke patients with hemiplegia

作　　者：吴七二 沈新培 董学超 陈凯 杜玲玲 Wu Qier;Shen Xinpei;Dong Xuechao;Chen Kai;Du Lingling(Department of Rehabilitation Medicine,the Second People's Hospital of Hefei,Hefei 230001,China)

机构地区：[1]安徽省合肥市第二人民医院康复医学科,合肥230001

出　　处：《中国综合临床》2022年第5期408-413,共6页Clinical Medicine of China

基　　金：安徽医科大学附属合肥医院院级课题(202038)。

摘　　要：目的观察分析脑卒中患者实施双、单桥式运动对相关核心肌群肌电活动的影响,探讨发现其规律和特征。方法选取2020年3月至2021年5月在安徽省合肥市第二人民医院康复医学科住院的脑卒中患者40例作为观察对象,进行前瞻性队列研究。应用表面肌电图(surface electromyography,sEMG)仪采集患者双、单桥式运动时竖脊肌、腹直肌、臀大肌和股二头肌表面肌电信号,分析其时域指标均方根值(root mean squar,RMS)和肌电积分值(integrate electromyography,IEMG)。符合正态分布计量资料以x¯±s表示;非正态分布数据以M(Q_(1),Q_(3))表示,采用Wilcoxon秩和检验比较两组相关肌群差异有无统计学意义。结果双桥运动时健、患侧臀大肌RMS[30.0(21.3,45.5)μV与24.0(14.0,35.8)μV]和IEMG[15.5.(10.0,23.0)μV·s与9.0(5.0,13.0)μV·s]值比较差异均有统计学意义(Z值分别为2.07、4.19,P值分别为0.039、<0.001);双桥运动时健、患侧股二头肌RMS[31.0(15.3,70.0)μV与17.0(11.0,28.8)μV]和IEMG[14.5(8.0,26.5)μV·s与7.0(5.0,10.8)μV·s]值比较差异均有统计学意义(Z值分别为3.44、3.64,P值分别为0.001、<0.001);单桥运动时健、患侧臀大肌RMS[38.5(32.3,46.0)μV与35.0(22.3,43.0)μV]和IEMG[16.5(12.0,22.8)μV·s与12.0(7.0,21.0)μV·s]值比较差异均有统计学意义(Z值分别为2.24、2.45,P值分别为0.025、0.014);单桥运动时健、患侧股二头肌RMS[38.0(15.3,70.0)μV与19.0(12.0,35.5)μV]和IEMG[16.0(10.0,27.0)μV·s与6.5(5.0,12.5)μV·s]值比较差异均有统计学意义(Z值分别为2.98、4.34,P值分别为0.003、<0.001);患侧双、单桥臀大肌的RMS[24.0(14.0,35.8)μV与35.0(22.3,43.0)μV]和IEMG[9.0(5.0,13.0)μV·s与12.0(7.0,21.0)μV·s]值比较差异均有统计学意义(Z值分别为2.24、1.99,P值分别为0.025、0.047)。结论双、单桥式运动对脑卒中偏瘫患者相关核心肌群有一定改善作用,且对于臀大肌激活程度单桥更优于双桥。Objective To observe and analyze the effect of double and single bridge exercise on the electromyographic activities of related core muscle groups in stroke patients,and to explore its rules and characteristics.Methods A prospective cohort study was conducted on 40 stroke patients hospitalized in the Department of rehabilitation medicine,Hefei second people's Hospital,Anhui Province from March 2020 to May 2021.The surface electromyography(sEMG)instrument was used to collect the surface electromyographic signals of erector spinalis,rectus abdominis,gluteus maximus and biceps femoris during double and single bridge exercise,and the root mean square(RMS)and integrated electromyography(iEMG)of the time domain indexes were analyzed.The measurement data conforming to normal distribution was expressed in x¯±s.The non normal distribution data was expressed in M(Q_(1),Q_(3)).Wilcoxon rank sum test was used to compare the difference between the two groups.Results There was significant difference between RMS(30.0(21.3,45.5)μV vs.24.0(14.0,35.8)μV)and IEMG(15.5.(10.0,23.0)μV·s vs.9.0(5.0,13.0)μV·s s)values of gluteus maximus on the healthy side and the affected side during double bridge exercise(Z values were 2.07,4.19;P values were 0.039,<0.001,respectively).There was significant difference in RMS(31.0(15.3,70.0)μV ratio of the healthy and affected biceps femoris 17.0(11.0,28.8)µV)and IEMG(14.5(8.0,26.5)μV·s vs.7.0(5.0,10.8)μV·s)values of biceps femoris on the healthy side during double bridge exercise(Z values were 3.44,3.64;P values were 0.001 and<0.001,respectively).There was significant difference between RMS(38.5(32.3,46.0)µV vs.35.0(22.3,43.0)µV)and IEMG(16.5(12.0,22.8)μV·s vs.12.0(7.0,21.0)μV·s)values of the gluteus maximus on the healthy side during single bridge exercise(Z values were 2.24,2.45;P values were 0.025,0.014,respectively).There was significant difference between RMS(38.0(15.3,70.0)µV vs.19.0(12.0,35.5)µV)and IEMG(16.0(10.0,27.0)μV·s vs.6.5(5.0,12.5)μV·s s)values of biceps femor

关 键 词：脑卒中 桥式运动 表面肌电 核心肌群 

分 类 号：R743.3[医药卫生—神经病学与精神病学]