血友病患者的平衡描记图和踝肌激活特征。

Posturographic and ankle muscle activation characteristics in patients with haemophilia.

机构信息

Department of Orthopedic and Trauma Surgery, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany.

Department of Sports Medicine, University of Wuppertal, Wuppertal, Germany.

出版信息

Haemophilia. 2019 Jan;25(1):136-143. doi: 10.1111/hae.13650. Epub 2018 Dec 6.

DOI:10.1111/hae.13650

PMID:30520541

Abstract

INTRODUCTION

The objective of this work was to examine the interrelations of posturographic and surface EMG (SEMG) characteristics of ankle muscles in patients with haemophilia while standing naturally.

METHODS

Surface EMG of five bilaterally recorded ankle muscles was conducted in 24 patients with haemophilia (PwH, age: 42 [11] years, mean [SD], 22 A, 2 B, 21 severe, 3 moderate) with median (quartiles) WFH orthopaedic joint score of 30 (20/39) points and 24 non-haemophilic controls (Con, age: 42 [12]). Force plate (IBS) signals were captured simultaneously during bipedal stance with eyes open. Load proportion of the left and right sides as well as heel and forefoot were calculated via four independent pressure transducers. Overall, weight distribution (WD) indices are reported with higher results representing a poorer WD.

RESULTS

Analyses of WD showed large differences between groups (PwH: 10.2 [5.4], Con: 5.2 [2.9], P < 0.001, d = 1.15). After clustering PwH, large effects (P = 0.02, η > 0.16) were found for amplitude ratios of the lateral gastrocnemius (LG) muscle. In PwH, the degree of joint alteration of the right lower limb was associated with load proportion of the left side (ρ > 0.64, P = 0.001).

CONCLUSION

Patients with greater dysbalance showed higher forefoot loads and appeared to compensate their altered joint situations with considerably higher amplitude ratios of LG. Further studies should investigate whether therapeutic interventions could alter postural alignment and muscle activation and how these can influence patients' joint function and symptoms.

摘要

简介

本研究旨在探讨血友病患者自然站立时踝关节肌肉的姿势描记和表面肌电图（sEMG）特征的相互关系。

方法

对 24 名血友病患者（PwH，年龄：42 [11]岁，均值[标准差]，22 名 A 型，2 名 B 型，21 名重度，3 名中度）和 24 名非血友病对照者（Con，年龄：42 [12]岁）进行双侧记录的踝关节 5 块肌肉的表面肌电图检测。使用 IBS 力板同步采集双足站立睁眼时的信号。通过 4 个独立的压力传感器计算左、右两侧以及足跟和前足的负荷比例。总体而言，报告了体重分布（WD）指数，结果越高表示 WD 越差。

结果

WD 分析显示两组间存在较大差异（PwH：10.2 [5.4]，Con：5.2 [2.9]，P < 0.001，d = 1.15）。聚类分析 PwH 后，发现外侧腓肠肌（LG）肌肉的振幅比有较大的效应（P = 0.02，η > 0.16）。在 PwH 中，右下肢关节改变的程度与左侧的负荷比例相关（ρ > 0.64，P = 0.001）。