中风后偏瘫和全瘫患者在对称功能活动期间选定躯干肌肉的激活情况。
Activation of selected trunk muscles during symmetric functional activities in poststroke hemiparetic and hemiplegic patients.
作者信息
Dickstein R, Heffes Y, Laufer Y, Ben-Haim Z
机构信息
Department of Physical Therapy, Sackler Faculty of Medicine, Tel-Aviv University, Israel.
出版信息
J Neurol Neurosurg Psychiatry. 1999 Feb;66(2):218-21. doi: 10.1136/jnnp.66.2.218.
OBJECTIVE
To compare the EMG activity between the recti abdominii muscles and between the lumbar erector spinae muscles in hemiparetic and hemiplegic patients during functional symmetric trunk movements and to compare patients' EMG activity profiles with those of healthy controls.
METHODS
EMG activity from the selected muscles was recorded during three symmetric and time controlled trunk exercises. Data analysis was based on values of cross correlations and of ratios between EMG activity of the bilateral corresponding muscles.
RESULTS
In all groups, the highest cross correlations were obtained for both muscles when the muscles acted as prime movers. For the recti abdominii muscles, these values in the patients were comparable with those of the healthy subjects, whereas for the extensor muscles, the highest synchronous activity was displayed in healthy subjects and the lowest in hemiplegic patients. Laterality differences in the amount of EMG activity of the recti abdominii muscles were not biased towards one side. For the extensor muscles, in the controls, the activation levels were higher in the left erector spinae muscle than in the right one in two of the three exercises. Similarly, in the extensor muscles of the hemiparetic patients, activity on the paretic side was higher than on the non-paretic side in two exercises.
CONCLUSIONS
In patients with a supratentorial poststroke hemiparesis or hemiplegia, bilateral corresponding axial trunk muscles co-contract during symmetric trunk activities. Synchronous activation is at its highest level during voluntary dynamic tasks and is greater in the recti abdominii than in the erector spinae muscles. For both muscles, EMG activation levels on the paretic side were not lower than on the non-paretic side. Thus, the assertion that the muscles on the paretic side are activated to a lesser extent than their counterparts on the non-paretic side during symmetric trunk movements was not confirmed.
目的
比较偏瘫和半身不遂患者在功能性对称躯干运动过程中腹直肌之间以及腰背部竖脊肌之间的肌电图（EMG）活动，并将患者的EMG活动情况与健康对照者进行比较。
方法
在三项对称且有时间控制的躯干运动过程中记录所选肌肉的EMG活动。数据分析基于双侧相应肌肉EMG活动的交叉相关性值和比率值。
结果
在所有组中，当肌肉作为主动肌时，两组肌肉均获得最高的交叉相关性。对于腹直肌，患者的这些值与健康受试者相当，而对于伸肌，健康受试者表现出最高的同步活动，半身不遂患者最低。腹直肌EMG活动量的侧别差异并不偏向一侧。对于伸肌，在对照组中，三项运动中的两项运动中左侧竖脊肌的激活水平高于右侧。同样，在偏瘫患者的伸肌中，两项运动中患侧的活动高于非患侧。
结论
在幕上中风后偏瘫或半身不遂的患者中，双侧相应的轴向躯干肌肉在对称躯干活动期间共同收缩。同步激活在自愿动态任务期间处于最高水平，并且在腹直肌中比在竖脊肌中更大。对于这两组肌肉，患侧的EMG激活水平均不低于非患侧。因此，关于在对称躯干运动期间患侧肌肉的激活程度低于非患侧对应肌肉的说法未得到证实。
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