不宁腿综合征（RLS）患者在步态站立阶段的远端肌肉活动改变。
Distal muscle activity alterations during the stance phase of gait in restless leg syndrome (RLS) patients.
机构信息
Biomechanics Laboratory, School of Physiology, University of the Witwatersrand, Faculty of Health Sciences, Medical School, Johannesburg, South Africa.
Biomechanics Laboratory, School of Physiology, University of the Witwatersrand, Faculty of Health Sciences, Medical School, Johannesburg, South Africa.
出版信息
Sleep Med. 2018 May;45:89-93. doi: 10.1016/j.sleep.2018.01.013. Epub 2018 Feb 15.
OBJECTIVE
To assess if there is a circadian variation in electromyographical (EMG) muscle activity during gait in restless legs syndrome (RLS) patients and healthy control participants.
METHODS
Gait assessment was done in 14 RLS patients and 13 healthy control participants in the evening (PM) and the morning (AM). Muscle activity was recorded bilaterally from the tibialis anterior (TA), lateral gastrocnemius (GL), rectus femoris (RF) and biceps femoris (BF) muscles.
RESULTS
A circadian variation during the stance phase in only TA (PM > AM, p < 0.005) and BF (PM < AM, p = 0.008) activity was observed in control participants. Conversely no circadian variation was seen in any muscles in the RLS patients. RLS patients had an increased TA and GL activity (RLS > Controls, p < 0.05) during early stance and decreased GL activity (RLS < Controls, p < 0.01) during terminal stance in comparison to control participants in the evening. No other significant differences were noted between RLS patients and control participants. Activation of GL during the swing phase was noted in 79% of RLS patients and in 23% of control participants in the morning compared to 71% and 38% in the evening, respectively.
CONCLUSION
EMG muscle activity shows no circadian variation in RLS patients. Evening differences in gait muscle activation patterns between RLS patients and control participants are evident. These results extend our knowledge about alterations in spinal processing during gait in RLS. A possible explanation for these findings is central pattern generator sensitization caused by increased sensitivity in cutaneous afferents in RLS patients.
目的
评估不安腿综合征（RLS）患者和健康对照者在行走时肌电图（EMG）肌肉活动是否存在昼夜变化。
方法
在晚上（PM）和早上（AM）对 14 名 RLS 患者和 13 名健康对照者进行步态评估。双侧胫骨前肌（TA）、外侧腓肠肌（GL）、股直肌（RF）和股二头肌（BF）肌肉活性均有记录。
结果
在对照组中，仅观察到 TA（PM>AM，p<0.005）和 BF（PM<AM，p=0.008）在支撑相期间存在昼夜变化。相反，RLS 患者的任何肌肉均未出现昼夜变化。与对照组相比，RLS 患者在早期支撑相中 TA 和 GL 活动增加（RLS>对照组，p<0.05），在终末期支撑相中 GL 活动减少（RLS<对照组，p<0.01）。RLS 患者与对照组之间未发现其他显著差异。与对照组相比，79%的 RLS 患者在早上的摆动相期间 GL 被激活，而 23%的对照组被激活，分别为 71%和 38%。
结论
RLS 患者的 EMG 肌肉活动无昼夜变化。RLS 患者和对照组之间在晚上的步态肌肉激活模式存在差异。这些结果扩展了我们对 RLS 患者步态期间脊髓处理变化的认识。这些发现的可能解释是 RLS 患者皮肤传入增加导致中枢模式发生器敏感性增加。
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