腰椎退行性脊柱炎患者在不同训练动作中特定肌肉疲劳度的差异  

Differences in specific muscle fatigue of patients with lumbar degenerative spondylitis in various training movements

作　　者：姜美驰 肖京[1] 娄爽 曹昺焱[1] 季宇宣 韩铮 谢曾 JIANG Meichi;XIAO Jing;LOU Shuang;CAO Bingyan;JI Yuxuan;HAN Zheng;XIE Zeng(Department of Rehabilitation Medicine,Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091,China)

机构地区：[1]中国中医科学院西苑医院康复医学科,北京100091

出　　处：《中华中医药杂志》2025年第2期512-516,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：中国中医科学院科技创新工程项目(No.CI2021A02010)。

摘　　要：目的:通过采集腰椎退行性脊柱炎(LDS)患者的3种核心稳定动作过程中的肌电信号,分析特定肌肉在不同动作下肌肉的疲劳度的差异,探讨肌肉疲劳程度与LDS疼痛症状的关系。方法:纳入116例LDS患者,通过无线表面肌电设备采集3种核心稳定动作[改良等长运动负荷试验(BST)、卷腹、仰卧单桥]过程中的疼痛侧与非疼痛侧的竖脊肌、多裂肌、腹直肌、腹外斜肌、臀大肌、臀中肌的中位频率(MF)和中位频率斜率(MPF)。结果:在改良BST测试过程中,无线表面肌电信号特征为疼痛侧竖脊肌、多裂肌的MF与MPF较非疼痛侧显著下降(P<0.01),在卷腹测试过程中,无线表面肌电信号特征为疼痛侧腹直肌、腹外斜肌的MF与MPF较非疼痛侧显著下降(P<0.01,P<0.05),在仰卧单桥测试过程中,无线表面肌电信号特征为疼痛侧竖脊肌、多裂肌、臀大肌、臀中肌的MF与MPF较非疼痛侧显著下降(P<0.01,P<0.05)。结论:LDS患者在不同动作模式下腰臀腹深层肌肉的耐力出现不同程度的下降,有可能导致腰椎节段稳定性的下降,从而导致腰痛症状不能得到有效控制。Objective:To analyze the differences in muscle fatigue of specific muscles during three core stability exercises among patients with lumbar degenerative spondylitis(LDS),and to explore the relationship between muscle fatigue resistance and LDS pain symptoms by collecting electromyographic(EMG)signals during these exercises.Methods:A total of 116 LDS patients were enrolled in this study.The median frequency(MF)and mean power frequency(MPF)values of the erector spinae,multifidus,rectus abdominis,external oblique,gluteus maximus,and gluteus medius muscles on both the painful and non-painful sides were collected during three core stability exercises [modified balance stability training(BST),crunch,and supine single-bridge],using wireless surface EMG equipment.Results:During the modified BST test,the MF and MPF values of the erector spinae and multifidus muscles on the painful side were significantly lower than those on the non-painful side(P<0.01).During the crunch test,the MF and MPF values of the rectus abdominis and external oblique muscles on the painful side were significantly lower than those on the non-painful side(P<0.01,P<0.05).During the supine single-bridge test,the MF and MPF values of the erector spinae,multifidus,gluteus maximus,and gluteus medius muscles on the painful side were significantly lower than those on the non-painful side(P<0.01,P<0.05).Conclusion:Patients with LDS exhibit varying degrees of decreased endurance in the deep lumbar,hip,and abdominal muscles during different exercise modes,which may lead to reduced lumbar segmental stability and ineffective control of low back pain symptoms.

关 键 词：腰椎退行性脊柱炎 表面肌电 核心稳定性 肌肉疲劳度 中位频率 

分 类 号：R681.51[医药卫生—骨科学]