Institute for Applied Health Research, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, United Kingdom.
Gait Posture. 2012 Jul;36(3):567-71. doi: 10.1016/j.gaitpost.2012.05.008. Epub 2012 Jun 20.
To determine within- and between-day reliability characteristics of electromyographic (EMG) activity patterns of selected lower leg muscles and kinematic variables in patients with rheumatoid arthritis (RA) and pes planovalgus.
Five patients with RA underwent gait analysis barefoot and shod on two occasions 1 week apart. Fine-wire (tibialis posterior [TP]) and surface EMG for selected muscles and 3D kinematics using a multi-segmented foot model was undertaken barefoot and shod. Reliability of pre-determined variables including EMG activity patterns and inter-segment kinematics were analysed using coefficients of multiple correlation, intraclass correlation coefficients (ICC) and the standard error of the measurement (SEM).
Muscle activation patterns within- and between-day ranged from fair-to-good to excellent in both conditions. Discrete temporal and amplitude variables were highly variable across all muscle groups in both conditions but particularly poor for TP and peroneus longus. SEMs ranged from 1% to 9% of stance and 4% to 27% of maximum voluntary contraction; in most cases the 95% confidence interval crossed zero. Excellent within-day reliability was found for the inter-segment kinematics in both conditions. Between-day reliability ranged from fair-to-good to excellent for kinematic variables and all ICCs were excellent; the SEM ranged from 0.60° to 1.99°.
Multi-segmented foot kinematics can be reliably measured in RA patients with pes planovalgus. Serial measurement of discrete variables for TP and other selected leg muscles via EMG is not supported from the findings in this cohort of RA patients. Caution should be exercised when EMG measurements are considered to study disease progression or intervention effects.
确定类风湿关节炎（RA）合并足纵弓塌陷患者小腿肌肉的肌电图（EMG）活动模式和运动学变量的日内和日间可靠性特征。
5 例 RA 患者在相隔 1 周的 2 次就诊时分别进行裸足和穿鞋步态分析。采用多节段足模型进行表面 EMG 和细导丝（比目鱼肌[TP]）EMG，以及 3D 运动学测量。使用多元相关系数、组内相关系数（ICC）和测量标准误差（SEM）分析包括 EMG 活动模式和节段间运动学在内的预定变量的可靠性。
在两种情况下，日内和日间的肌肉激活模式均为中等到良好，在两种情况下，所有肌肉群的离散时间和幅度变量均高度可变，但 TP 和腓骨长肌尤其差。SEM 范围为站立期的 1%至 9%和最大随意收缩的 4%至 27%；在大多数情况下，95%置信区间穿过零。在两种情况下，节段间运动学的日内可靠性均极好。在两种情况下，运动学变量的日间可靠性均为中等到极好，所有 ICC 均极好；SEM 范围为 0.60°至 1.99°。
在合并足纵弓塌陷的 RA 患者中，可以可靠地测量多节段足运动学。通过 EMG 对 TP 和其他选定的腿部肌肉进行离散变量的连续测量，在本 RA 患者队列中没有得到支持。在考虑 EMG 测量来研究疾病进展或干预效果时，应谨慎行事。
