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脑性瘫痪儿童下肢肌肉的运动控制。

Motor control of the lower extremity musculature in children with cerebral palsy.

机构信息

Department of Physical Therapy, Munroe-Meyer Institute for Genetics and Rehabilitation, University of Nebraska Medical Center, Omaha, NE, United States.

出版信息

Res Dev Disabil. 2013 Apr;34(4):1134-43. doi: 10.1016/j.ridd.2012.12.014. Epub 2013 Jan 30.

Abstract

The aim of this investigation was to quantify the differences in torque steadiness and variability of the muscular control in children with cerebral palsy (CP) and typically developing (TD) children. Fifteen children with CP (age=14.2±0.7 years) that had a Gross Motor Function Classification System (GMFCS) score of I-III and 15 age and gender matched TD children (age=14.1±0.7 years) participated in this investigation. The participants performed submaximal steady-state isometric contractions with the ankle, knee, and hip while surface electromyography (sEMG) was recorded. An isokinetic dynamometer was used to measure the steady-state isometric torques while the participants matched a target torque of 20% of the subject's maximum voluntary torque value. The coefficient of variation was used to assess the amount of variability in the steady-state torque, while approximate entropy was used to assess the regularity of the steady-state torque over time. Lastly, the distribution of the power spectrum of the respective sEMG was evaluated. The results of this investigation were: 1) children with CP had a greater amount of variability in their torque steadiness at the ankle than TD children, 2) children with CP had a greater amount of variability at the ankle joint than at the knee and hip joint, 3) the children with CP had a more regular steady-state torque pattern than TD children for all the joints, 4) the ankle sEMG of children with CP was composed of higher harmonics than that of the TD children.

摘要

本研究旨在量化脑瘫(CP)儿童与正常发育(TD)儿童肌肉控制的扭矩稳定性和可变性差异。15 名 CP 儿童(年龄=14.2±0.7 岁)和 15 名年龄和性别匹配的 TD 儿童(年龄=14.1±0.7 岁)参与了本研究。参与者在踝关节、膝关节和髋关节进行亚最大稳态等长收缩,同时记录表面肌电图(sEMG)。等速测力计用于测量稳态等速扭矩,同时参与者将目标扭矩匹配为受试者最大随意扭矩值的 20%。变异系数用于评估稳态扭矩的变化量,而近似熵用于评估稳态扭矩随时间的规律性。最后,评估了各自 sEMG 的功率谱分布。本研究的结果为:1)CP 儿童的踝关节扭矩稳定性变化量大于 TD 儿童,2)CP 儿童的踝关节扭矩变化量大于膝关节和髋关节,3)CP 儿童的所有关节的稳态扭矩模式比 TD 儿童更规则,4)CP 儿童的踝关节 sEMG 比 TD 儿童包含更高的谐波。

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