胫骨前肌临床12种常用训练方式的激活比较  

Comparison of twelve commonly used training methods for activating the anterior tibial muscle in clinical practice

作　　者：徐璇 刘光磊 段文婷 孟繁媛 唐欣 周娅 XU Xuan;LIU Guanglei;DUAN Wenting(The School of Rehabilitation,Kunming Medical University,Kunming,650500)

机构地区：[1]昆明医科大学康复学院,云南省昆明市650500 [2]云南省第三强制隔离戒毒所

出　　处：《中国康复医学杂志》2025年第1期67-72,100,共7页Chinese Journal of Rehabilitation Medicine

基　　金：昆明医科大学2023年度大学生创新创业教育项目(CXCY2023005)。

摘　　要：目的:通过量化和比较临床康复训练常用的12种训练方式在胫骨前肌激活的肌电信号振幅变化,以确定胫骨前肌激活最佳方式。方法:研究选取16名健康大学生作为目标人群,借助表面肌电图量化受试者在12项运动时胫骨前肌的活动水平,使用单因素方差分析和独立样本t检验对标准化处理后的表面肌电图的积分肌电值(integrated electromyography,iEMG)、均方根值(root mean square,RMS)进行分析。结果:在12种针对胫骨前肌激活的训练中,最大激活方式为T2“双脚站立(泡沫垫)踝关节从零度位开始背屈到最大角度”,其次分别为T1“双脚站立(地板),踝关节从零度位开始背屈到最大角度”和T5“双脚站立(泡沫垫)踝关节从零度位”做“足背屈+内翻”到最大角度;激活最小为T12“受试者以自然步伐在地面上行走”;其次为T6“受试者从30cm高台阶跳到地板上”和T7“受试者从30cm高台阶跳到泡沫垫上”。在RMS比较中,T12、T6、T7与T2激活情况存在显著性差异(P<0.05);T12、T6与T1激活情况存在显著性差异(P<0.05)。在iEMG比较中,T12、T6、T7与T2、T1和T5激活相比存在显著性差异(P<0.05),T12、T6与T3激活相比存在显著性差异(P<0.05),其他测试之间未发现明显显著性差异。此外,在男女生之间对12个测试激活情况进行比较,发现男性胫骨前肌激活程度整体大于女性,但未发现明显差异。结论:增加负重、降低支撑面稳定性、增加肌肉初长度和选择与患者能力匹配的难度训练方式可以增加胫骨前肌激活,而功能性活动和平衡策略使用在健康人群中对胫骨前肌激活并不如其他针对性测试。其中,在健康受试者中对胫骨前肌激活最大的训练方式是双脚站立踝关节从零度位开始背屈到最大角度。本研究结果为临床康复治疗与损伤预防处方的选择提供了有关胫骨前肌在特定运动中相对激活情况信息,可作为运动处方制�Objective:To quantify and compare electromyographic(EMG)amplitude changes in the activation of the tibialis anterior muscle by 12 commonly used training methods in clinical rehabilitation training,and to identify the optimal activation method of the tibialis anterior muscle.Method:Sixteen healthy college students were participated in the study.Surface electromyography(sEMG)was used to quantify the activity level of the tibialis anterior muscle during 12 tests.Univariate variance was used to analyze the integrated electromyography(iEMG)and root mean square(RMS).Result:Among the 12 training methods targeting the activation of the tibialis anterior muscle,the maximum activation mode is T2"double feet standing(foam pad)ankle joint from zero to the maximum angle",followed by T1"double feet standing(floor),ankle joint from zero to the maximum angle"and T5"double feet standing(foam pad)ankle joint from zero to the maximum angle"foot dorsiflexion and invertion to the maximum angle;The minimum activation was T12"the subject walked on the ground with a natural step",followed by T6"the subject jumped from a 30cm high step to the floor"and T7"the subject jumped from a 30cm high step to a foam pad".In RMS comparison,there was a statistical difference between the activation of T12,T6,T7,and T2(P<0.05),and between the activation of T12,T6,and T1(P<0.05).In iEMG comparison,there were statistical differences(P<0.05)between the activation of T12,T6,T7 and T2,T1,and T5(P<0.05),and between the activation of T12,T6,and T3,with no significant statistical difference noted other comparisons.When comparing activation between male and female participants across the 12 tests,males generally had higher activation in the anterior tibial muscle than that in female,but no significant statistical difference was found.Conclusion:Increasing weight bearing,reducing support surface stability,increasing initial muscle initial length,and selecting difficulty training methods matching patient abilities can enhance the activation of anterior tibial mus

关 键 词：胫骨前肌 激活 表面肌电图 

分 类 号：R493[医药卫生—康复医学]