Dwyer Maureen K, Stafford Kelly, Mattacola Carl G, Uhl Timothy L, Giordani Mauro
Department of Rehabilitation Sciences, University of Kentucky, Lexington, KY, USA.
Clin Biomech (Bristol). 2013 Aug;28(7):757-61. doi: 10.1016/j.clinbiomech.2013.07.007. Epub 2013 Aug 1.
Neuromuscular alterations have been reported for patients with osteoarthritis of the hip joint; however, the underlying cause associated with altered gluteus medius muscle function has not been examined. This study assessed electromyographic amplitudes of the gluteus medius muscles during function in patients with unilateral end-stage osteoarthritis of the hip joint compared to controls.
Patients with unilateral end-stage hip joint osteoarthritis (n=13) and asymptomatic control participants (n=17) participated. Average root-mean squared muscle amplitudes represented as a percent of maximum voluntary isometric contraction for both the involved and uninvolved limb gluteus medius muscles were analyzed during step up, step down, and gait. The association between muscle activation and impact forces during stepping tasks was assessed.
Patients with hip osteoarthritis exhibited increased gluteus medius muscle electromyographic amplitudes bilaterally during stair ascent, stair descent, and gait compared to controls, regardless of which limb they led. Involved limb muscle activity was inversely related to impact force during step down onto the ipsilateral limb.
Patients with hip osteoarthritis demonstrated increased gluteus medius muscle activation levels during stepping tasks and gait when compared to controls. The increased activation is most likely a compensatory response to muscle weakness. Therefore, application of strengthening exercises which target the gluteal muscles should assist in neuromuscular control and result in improved strength for patients with hip joint osteoarthritis.
已有报道称髋关节骨关节炎患者存在神经肌肉改变；然而，与臀中肌功能改变相关的潜在原因尚未得到研究。本研究评估了单侧终末期髋关节骨关节炎患者与对照组在功能活动期间臀中肌的肌电图幅度。
纳入单侧终末期髋关节骨关节炎患者（n = 13）和无症状对照参与者（n = 17）。在上下台阶和步态过程中，分析患侧和未患侧肢体臀中肌的平均均方根肌肉幅度，以最大自主等长收缩的百分比表示。评估了步行动作任务期间肌肉激活与冲击力之间的关联。
与对照组相比，髋关节骨关节炎患者在上下楼梯及步态过程中双侧臀中肌的肌电图幅度均增加，无论其主导哪一侧肢体。患侧肢体肌肉活动与患侧肢体下台阶时的冲击力呈负相关。
与对照组相比，髋关节骨关节炎患者在步行动作任务和步态期间表现出臀中肌激活水平增加。这种激活增加很可能是对肌肉无力的一种代偿反应。因此，针对臀肌的强化训练应用应有助于神经肌肉控制，并改善髋关节骨关节炎患者的力量。
