Goudy N, McLean L
School of Rehabilitation Therapy, Queens University, 31 George Street, Kingston, ON, Canada.
Eur J Appl Physiol. 2006 May;97(2):196-209. doi: 10.1007/s00421-006-0162-4. Epub 2006 Mar 28.
Complaints of chronic trapezius muscle pain among computer workers have increased in prevalence during the last decade. Currently there is no clear understanding of the pathophysiological mechanisms involved in affected muscles. The major objective of this work was to determine if measurable electrophysiological differences exist between the trapezius muscles in individuals suffering from trapezius myalgia (TM) and occupation-matched pain-free control subjects. Myoelectric signal (MES) data were recorded from the upper trapezius muscle while subjects with and without myalgia performed a standardized series of postural and arm-holding tasks. MES variables reflecting muscle fatigue, muscle tension and motor control strategies were analyzed to determine their potential ability to distinguish between the two groups. One variable, RestTime, was found to be significantly different between the groups but it was not specific enough to predict group association. A multivariate logistic regression analysis yielded a model that separated the two groups with better than 70% sensitivity and 70% specificity. The variables included in the model reflect differences in trapezius muscle activity between the groups, particularly related to motor control and/or active muscle tension, but not fatigue. The model was tested using a small sample of new data, which again produced a good sensitivity (85.7%) but not specificity (42.9%). To the authors' knowledge, this is the first objective MES-based model that has successfully classified subjects with or without TM based on a simple clinical test. Further work with this model might result in understanding the pathophysiology of TM, assisting with clinical diagnosis, and testing the effect of various treatment interventions.
在过去十年中,电脑工作者慢性斜方肌疼痛的患病率有所上升。目前,对于受累肌肉所涉及的病理生理机制尚无明确认识。这项研究的主要目的是确定患有斜方肌肌痛(TM)的个体与职业匹配的无疼痛对照受试者的斜方肌之间是否存在可测量的电生理差异。在有肌痛和无肌痛的受试者执行一系列标准化的姿势和持臂任务时,记录上斜方肌的肌电信号(MES)数据。分析反映肌肉疲劳、肌肉张力和运动控制策略的MES变量,以确定它们区分两组的潜在能力。发现一个变量RestTime在两组之间有显著差异,但它的特异性不足以预测组间关联。多元逻辑回归分析得出一个模型,该模型对两组的区分灵敏度和特异性均高于70%。模型中包含的变量反映了两组之间斜方肌活动的差异,特别是与运动控制和/或主动肌肉张力有关,但与疲劳无关。使用一小部分新数据对该模型进行测试,再次获得了良好的灵敏度(85.7%),但特异性不高(42.9%)。据作者所知,这是第一个基于MES的客观模型,该模型已通过简单的临床测试成功地对患有或未患有TM的受试者进行了分类。对该模型的进一步研究可能有助于理解TM的病理生理学,辅助临床诊断,并测试各种治疗干预措施的效果。