University Outpatient Clinic, Sports Medicine and Sports Orthopaedics, University of Potsdam, Am Neuen Palais 10 - Haus 12, 14469 Potsdam, Germany.
J Electromyogr Kinesiol. 2011 Jun;21(3):499-505. doi: 10.1016/j.jelekin.2010.11.010. Epub 2011 Jan 8.
Neuromuscular control in functional situations and possible impairments due to Achilles tendinopathy are not well understood. Thirty controls (CO) and 30 runners with Achilles tendinopathy (AT) were tested on a treadmill at 3.33 ms(-1) (12 km h(-1)). Neuromuscular activity of the lower leg (tibialis anterior, peroneal, and gastrocnemius muscle) was measured by surface electromyography. Mean amplitude values (MAV) for the gait cycle phases preactivation, weight acceptance and push-off were calculated and normalised to the mean activity of the entire gait cycle. MAVs of the tibialis anterior did not differ between CO and AT in any gait cycle phase. The activation of the peroneal muscle was lower in AT in weight acceptance (p=0.006), whereas no difference between CO and AT was found in preactivation (p=0.71) and push-off (p=0.83). Also, MAVs of the gastrocnemius muscle did not differ between AT and CO in preactivity (p=0.71) but were reduced in AT during weight acceptance (p=0.001) and push-off (p=0.04). Achilles tendinopathy does not seem to alter pre-programmed neural control but might induce mechanical deficits of the lower extremity during weight bearing (joint stability). This should be addressed in the therapy process of AT.
在功能情况下的神经肌肉控制以及跟腱炎可能导致的功能障碍了解甚少。本研究测试了 30 名对照组(CO)和 30 名跟腱炎患者(AT)在跑步机上以 3.33 ms(-1)(12 km h(-1))的速度跑步。通过表面肌电图测量小腿(胫骨前肌、腓肠肌和比目鱼肌)的神经肌肉活动。计算步态周期各相位(预激活、承重和蹬离)的均方根振幅值(MAV),并将其归一化为整个步态周期的平均活动。在任何步态周期阶段,CO 和 AT 的胫骨前肌 MAV 均无差异。在承重阶段(p=0.006),AT 的腓肠肌激活程度较低,而在预激活(p=0.71)和蹬离(p=0.83)阶段,CO 和 AT 之间没有差异。此外,在预激活(p=0.71)阶段,AT 和 CO 的比目鱼肌 MAV 没有差异,但在承重(p=0.001)和蹬离(p=0.04)阶段,AT 的 MAV 降低。跟腱炎似乎不会改变预先编程的神经控制,但可能会在承重时引起下肢的机械缺陷(关节稳定性)。这应该在 AT 的治疗过程中加以解决。