前交叉韧带重建后外侧骨关节炎为主的个体使用减荷支具对下肢肌电图活动的影响。
Influence of an unloader brace on lower limb electromyographic activity in individuals with predominant lateral osteoarthritis after anterior cruciate ligament reconstruction.
机构信息
La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Bundoora, Victoria, Australia; The University of Western Ontario, Collaborative Training Program in Musculoskeletal Research, and Bone and Joint Institute, Faculty of Health Sciences, London, Ontario, Canada.
School of Health & Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia.
出版信息
Braz J Phys Ther. 2020 Jul-Aug;24(4):342-348. doi: 10.1016/j.bjpt.2019.05.004. Epub 2019 Jun 1.
OBJECTIVE
To determine the immediate effects of a varus unloader knee brace on lower-limb electromyographic activity in individuals with lateral knee osteoarthritis and valgus malalignment after anterior cruciate ligament reconstruction.
METHODS
Electromyographic data were recorded in 19 individuals with lateral knee osteoarthritis and valgus malalignment after anterior cruciate ligament reconstruction during walking under three conditions: (i) no brace, (ii) unadjusted brace (no varus adjustment), and adjusted brace (varus adjustment). Variables of interest were statistically analyzed using repeated measures analysis of variance.
RESULTS
There were no significant differences in muscle co-contraction between the three test conditions. The adjusted brace resulted in delayed offset of gluteus maximus (mean difference [95% CI]: 72ms [24, 119]), and earlier onset of gluteus medius (59ms [21, 97]) compared to no brace. The adjusted brace delayed onset of lateral gastrocnemius compared to no brace (53ms [28, 78]) and the unadjusted brace (39ms [7, 71]) and reduced average activation amplitude of gluteus maximus (-4mV [-6, -1]) and lateral gastrocnemius (-9mV [-16, -2]) compared to no brace.
CONCLUSIONS
The unloader brace did not produce significant changes in muscle co-contraction in individuals with lateral knee osteoarthritis and valgus malalignment after anterior cruciate ligament reconstruction. Significant changes in gluteal and gastrocnemius muscle activation timing and amplitude were observed, however, it is not clear whether these changes are of clinical importance.
目的
确定外翻型减载膝关节支具对前交叉韧带重建后外侧膝关节骨关节炎伴外翻畸形患者下肢肌电图活动的即刻影响。
方法
在 19 例前交叉韧带重建后外侧膝关节骨关节炎伴外翻畸形患者行走时，分别在 3 种情况下（i）无支具、（ii）未调整支具（无内翻调整）和调整支具（内翻调整）记录肌电图数据。使用重复测量方差分析对感兴趣的变量进行统计学分析。
结果
在 3 种测试条件下，肌肉协同收缩无显著差异。与无支具相比，调整后的支具使臀大肌延迟（平均差异 [95%CI]：72ms [24, 119]），臀中肌提前（59ms [21, 97]）。与无支具相比，调整后的支具使外侧腓肠肌的起始时间延迟（53ms [28, 78]），与未调整的支具相比延迟（39ms [7, 71]），并降低了臀大肌（-4mV [-6, -1]）和外侧腓肠肌（-9mV [-16, -2]）的平均激活幅度。
结论
在前交叉韧带重建后外侧膝关节骨关节炎伴外翻畸形患者中，减载支具并未显著改变肌肉协同收缩。然而，观察到臀肌和腓肠肌激活时间和幅度的显著变化，但尚不清楚这些变化是否具有临床意义。
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