Department of Pharmacy and Applied Science, College of Science, Health and Engineering, La Trobe University, Bendigo, Victoria, Austalia.
Sport, Exercise and Rehabilitation Research Focus Area, La Trobe University, Bendigo, Victoria, Australia.
Scand J Med Sci Sports. 2019 May;29(5):696-705. doi: 10.1111/sms.13379. Epub 2019 Jan 25.
The gluteal muscles act as stabilizers of the hip joint and are important for the maintenance of hip function. Atrophy and weakness of the gluteal muscles have been identified in people with hip OA, but it is not known whether these muscles also exhibit altered activity patterns. The aim of this study was to compare gluteal muscle activity in people with hip OA and healthy older adults. Fine-wire intramuscular electrodes were inserted into the three segments of gluteus medius (GMed) and two segments of gluteus minimus (GMin) in 20 participants with unilateral hip OA and 20 age- and gender-matched controls. Electromyographic activity of these muscle segments was examined during walking along a 10 m walkway. Peak amplitude, average amplitude, and time to peak were compared between groups during the stance phase of the gait cycle. During early stance, the OA group demonstrated a higher burst of activity in posterior GMin (P = 0.02) and trends toward a higher peak in anterior GMin. Both groups displayed peak activity in anterior GMin in the early stance phase in contrast to previous reports in young adults. This early burst of muscle activity was more pronounced with increasing severity of OA. No differences were identified in GMed activity. While altered GMin activity is associated with aging, these changes were more pronounced in participants with hip OA. To reduce disability associated with hip OA, future rehabilitation programs should consider targeted gait strategies and exercises for GMin.
臀肌是髋关节的稳定器，对于维持髋关节功能很重要。患有髋骨关节炎的人群中已经发现臀肌萎缩和无力，但尚不清楚这些肌肉是否也表现出活动模式的改变。本研究旨在比较髋骨关节炎患者和健康老年人的臀肌活动。将细金属丝肌内电极插入 20 名单侧髋骨关节炎患者和 20 名年龄和性别匹配的对照组的臀中肌（GMed）的三个节段和臀小肌（GMin）的两个节段。在沿着 10 米走道行走的过程中，检查这些肌肉节段的肌电图活动。在步态周期的站立阶段，比较组间的峰值幅度、平均幅度和达到峰值的时间。在早期站立阶段，OA 组在臀小肌后段（P=0.02）的活动爆发较高，在前臀小肌有较高峰值的趋势。与年轻人的先前报告相反，两组在前臀小肌都在早期站立阶段显示出峰值活动。这种早期肌肉活动爆发随着 OA 严重程度的增加而更加明显。在 GMed 活动中未发现差异。虽然臀小肌活动的改变与衰老有关，但在髋骨关节炎患者中，这些变化更为明显。为了减少与髋骨关节炎相关的残疾，未来的康复计划应考虑针对臀小肌的特定步态策略和锻炼。
