Allison K, Salomoni S E, Bennell K L, Wrigley T V, Hug F, Vicenzino B, Grimaldi A, Hodges P W
Centre for HealthExercise and Sports Medicine, Department of Physiotherapy, The University of Melbourne, Parkville, Victoria, Australia.
School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia.
Scand J Med Sci Sports. 2018 Feb;28(2):686-695. doi: 10.1111/sms.12942. Epub 2017 Sep 18.
The external hip adduction moment during walking is greater in individuals with gluteal tendinopathy (GT) than pain-free controls. Although this likely represents a greater demand on the hip abductor muscles implicated in GT, no study has investigated activation of these muscles in GT. For this purpose, fine wire electrodes were inserted into the segments of the gluteus minimus and medius muscles, and surface electrodes placed on the tensor fascia lata, upper gluteus maximus, and vastus lateralis muscles of eight individuals with, and eight without, GT. Participants underwent six walking trials. Individual muscle patterns were compared between groups using a wavelet-based linear effects model and muscle synergy analysis performed using non-negative matrix factorization to evaluate muscle activation patterns, within- and between-participant variability. Compared to controls, individuals with GT exhibited a more sustained initial burst of the posterior gluteus minimus and middle gluteus medius muscle segments. Two muscle synergies were identified; Synergy-1 activated in early-mid stance and Synergy-2 in early stance. In GT participants, posterior gluteus minimus and posterior gluteus medius and tensor fascia lata contributed more to Synergy-1 active during the period of single leg support. Participants with GT exhibited reduced within-participant variability of posterior gluteus medius and reduced between-participant variability of anterior gluteus minimus and medius and upper gluteus maximus. In conclusion, individuals with GT exhibit modified muscle activation patterns of the hip abductor muscles during walking, with potential relevance for gluteal tendon loading.
与无疼痛的对照组相比，臀肌腱病（GT）患者在行走过程中的髋关节外展力矩更大。尽管这可能意味着参与GT的髋外展肌承受了更大的负荷，但尚无研究调查GT患者这些肌肉的激活情况。为此，将细钢丝电极插入臀小肌和臀中肌各节段，并将表面电极置于8名GT患者和8名非GT患者的阔筋膜张肌、臀大肌上部和股外侧肌上。参与者进行了6次步行试验。使用基于小波的线性效应模型比较两组之间的个体肌肉模式，并使用非负矩阵分解进行肌肉协同分析，以评估肌肉激活模式、参与者内部和参与者之间的变异性。与对照组相比，GT患者臀小肌后部和臀中肌中部节段的初始爆发更为持续。识别出两种肌肉协同作用；协同作用1在站立中期激活，协同作用2在站立早期激活。在GT参与者中，臀小肌后部、臀中肌后部和阔筋膜张肌在单腿支撑期对协同作用1的激活贡献更大。GT参与者表现出臀中肌后部参与者内部变异性降低，以及臀小肌前部、臀中肌前部和臀大肌上部参与者之间变异性降低。总之，GT患者在行走过程中表现出髋外展肌的肌肉激活模式改变，这可能与臀肌腱负荷有关。
