腰椎斜扳治疗小关节紊乱的多种运动下肌电研究  

Surface electromyography in multi-exercises for facet disorder before and after lumbar oblique wrench manipulation

作　　者：黄萍[1] 卢玄 靳杰 戚威臣 陈博[1] 钟慧敏 沈峥嵘[3] HUANG Ping;LU Xuan;JIN Jie;QI Wei-chen;CHEN Bo;ZHONG Hui-min;SHEN Zheng-rong(Shanghai Institute of Traumatology and Orthopaedics,Shanghai 200025,China;School of Medicine,Yangtze University,Jingzhou 434023,China;Department of Tuina,Ruijin Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai 200025,China)

机构地区：[1]上海市伤骨科研究所,上海200025 [2]长江大学医学院,湖北荆州434023 [3]上海交通大学医学院附属瑞金医院推拿科,上海200025

出　　处：《中国矫形外科杂志》2023年第19期1792-1796,共5页Orthopedic Journal of China

基　　金：上海市卫生和计划生育委员会中医药科研课题项目(编号:2020LP034);上海市卫生和计划生育委员会面上项目(编号:202140130)。

摘　　要：[目的]定量评价腰椎斜扳治疗小关节紊乱患者在多种运动下的肌电变化。[方法]2020年9月—2021年12月上海交通大学医学院附属瑞金医院推拿科的小关节紊乱患者15例,和相匹配的正常人10例纳入本研究。采用临床量表评分和表面肌电图对腰椎斜扳治疗前后的小关节紊乱患者和正常人进行几种运动的状态下检测,比较临床状态与运动过程中腰背肌的肌电活动差异。[结果]与治疗前相比,治疗后1个月患者VAS评分显著减少[(6.2±0.9),(1.5±0.6),P<0.05],而JOA评分显著增加[(11.9±1.4),(22.7±3.3),P<0.05]。肌电检测方面,患者在常态行走、右足跨越障碍行走、左足跨越障碍行走、弯腰、弯腰提物等不同运动方式下,治疗后1个月患者左右竖脊肌、左右多裂肌的平均肌电振幅和中位频率均较治疗前显著降低(P<0.05),治疗后左右竖脊肌、左右多裂肌的平均肌电振幅和中位频率与正常人相比差异无统计学意义(P>0.05)。[结论]腰椎斜扳治疗小关节紊乱可以缓解疼痛,降低竖脊肌和多裂肌的异常电活动。[Objective]To quantitatively evaluate the surface electromyography(sEMG)changes in multi-exercises for facet disorder before and after lumbar oblique wrench manipulation.[Methods]From September 2020 to December 2021,15 patients with facet disorder and 10 matched normal subjects were included in this study in the Department of Tuina,Ruijin Hospital affiliated to Shanghai Jiao Tong Uni-versity.The clinical score evaluation and sEMG under several exercise states were conducted before and after lumbar oblique wrench manip-ulation.The difference in clinical state and the myoelectric activity of lumbar muscles were compared before and after lumbar oblique wrench manipulation in the patient with the normal subject.[Results]Compared with those before treatment,the VAS score for pain signifi-cantly reduced[(6.2±0.9),(1.5±0.6),P<0.05],while the JOA score significantly increased[(11.9±1.4),(22.7±3.3),P<0.05]1 month after treatment in the patients.In terms of sEMG,the mean amplitude and median frequency of the right and left erector,as well as the left and right multifidus significantly decreased 1 month after treatment compared with those before treatment under different exercise modes,includ-ing normal walking,right foot over obstacle,left foot over obstacle,bending and bending load(P<0.05).After treatment,the mean sEMG am-plitude and median frequency of right and left erector and left and right multifidus were not significantly different from those of normal peo-ple(P>0.05).[Conclusion]Lumbar oblique wrench manipulation does relieve pain and reduce the abnormal electrical activity of erector and multifidus muscles in patients with facet disorders.

关 键 词：小关节紊乱 腰椎斜扳治疗 表面肌电图 

分 类 号：R687[医药卫生—骨科学]