Gagnon Dany, Koontz Alicia M, Brindle Eric, Boninger Michael L, Cooper Rory A
Human Engineering Research Laboratories, Department of Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA 15206, USA.
J Rehabil Res Dev. 2009;46(9):1099-108. doi: 10.1682/jrrd.2009.02.0012.
This study's main objective was to determine if upper-limb (UL) muscular demand was reduced when individuals with a spinal cord injury (SCI) performed a sitting pivot transfer (SPT) in the preferred direction compared with that in a nonpreferred direction. Fourteen individuals (mean +/- standard deviation age 47.0 +/- 8.3 yr, height 1.80 +/- 0.08 m, and weight 75.3 +/- 11.3 kg) with SCI levels ranging from the sixth cervical to first sacral vertebra levels volunteered to participate in this study during the 2008 National Disabled Veterans Winter Sports Clinic. Surface electromyography (EMG) was used to record activity of the biceps, triceps, deltoid, pectoralis major, trapezius, and latissimus dorsi bilaterally during SPTs. These transfers were performed in each of the preferred and nonpreferred directions from the individuals' wheelchairs to a padded tub bench of even height. To quantify electromyographic muscular utilization ratio (MUR(EMG)), we normalized EMG data recorded during the transfer tasks to values obtained during static maximum voluntary contraction and then multiplied this ratio by 100 to obtain a percentage MUR(EMG) (%MUR(EMG)). The overall peak %MUR(EMG) and the area under the %MUR(EMG) curve were selected as primary outcome measures. Similar peak %MUR(EMGs) were found between the preferred and nonpreferred transfer directions for all muscles from which data were recorded (p = 0.053 to 0.961). The peak %MUR(EMGs) were also found to be similar between the leading and trailing ULs during the transfers in all muscles from which data were recorded (p = 0.125 to 0.838), except for the anterior deltoid, which was found to be solicited the most in the trailing UL (p = 0.008). Comparable areas under the %MUR(EMG) curves were calculated between the preferred and nonpreferred transfer directions for all muscles (p = 0.289 to 0.678) and between the leading and trailing ULs (p = 0.104 to 0.946). These results indicate that direction preference expressed by individuals with SCI when transferring between seats of even height is not explained by relative muscular demand differences.
本研究的主要目的是确定脊髓损伤（SCI）患者在以偏好方向进行坐立位转移（SPT）时，与以非偏好方向进行转移相比，上肢（UL）的肌肉需求是否降低。14名脊髓损伤患者（年龄均值±标准差为47.0±8.3岁，身高1.80±0.08米，体重75.3±11.3千克），损伤平面范围从第六颈椎至第一骶椎，他们在2008年全国残疾退伍军人冬季运动诊所期间自愿参与本研究。在坐立位转移过程中，使用表面肌电图（EMG）双侧记录肱二头肌、肱三头肌、三角肌、胸大肌、斜方肌和背阔肌的活动。这些转移操作在患者从轮椅转移至高度一致的带衬垫浴凳的偏好方向和非偏好方向上分别进行。为了量化肌电图肌肉利用率（MUR(EMG)），我们将转移任务期间记录的EMG数据归一化为静态最大自主收缩期间获得的值，然后将该比率乘以100以获得百分比MUR(EMG)（%MUR(EMG)）。总体峰值%MUR(EMG)和%MUR(EMG)曲线下面积被选为主要结局指标。在记录数据的所有肌肉中，偏好转移方向和非偏好转移方向之间的峰值%MUR(EMG)相似（p = 0.053至0.961）。在记录数据的所有肌肉的转移过程中，主导上肢和非主导上肢之间的峰值%MUR(EMG)也相似（p = 0.125至0.838），除了前三角肌，其在非主导上肢中被激活程度最高（p = 0.008）。在所有肌肉的偏好转移方向和非偏好转移方向之间（p = 0.289至0.678）以及主导上肢和非主导上肢之间（p = 0.104至0.946），计算出的%MUR(EMG)曲线下面积相当。这些结果表明，脊髓损伤患者在高度一致的座椅之间转移时所表现出的方向偏好，并不能由相对肌肉需求差异来解释。
