Lennon Olive, Logeswaran Kaushika, Mistry Srushti, Moore Tara, Severini Giacomo, Cornall Catherine, O'Sullivan Cliona, McCarthy Persson Ulrik
School of Public Health, Physiotherapy and Sports Science.
School of Electrical and Electronic Engineering, University College.
Physiother Can. 2019 Fall;71(4):309-318. doi: 10.3138/ptc-2018-0012.
Neurodevelopmental techniques are commonly used in upper limb rehabilitation, but little evidence supports the facilitation techniques associated with this concept. This exploratory study determined whether a facilitation technique at the triceps muscle affected scapulothoracic muscle activity during reach in healthy participants compared with self-selected posture and reach. The secondary aim was to determine whether muscle activation levels differed between the facilitation technique and the optimized posture or guided movement. We also hypothesized that activity in the scapular stabilizers (lower trapezius [LT] and serratus anterior [SA]) would be increased during the facilitated movement than in the other conditions. The study included 17 healthy participants (aged 20-70 y). Surface electromyography recorded muscle activity in the upper trapezius (UT), middle trapezius (MT), and LT muscles and in the SA, middle deltoid (MD), and triceps during five performance conditions. We used Friedman's test to explore differences in muscle activity across conditions and Bonferroni's post hoc test to explore the differences between conditions. The facilitation technique produced decreased activity in the SA, MD, and triceps muscles ( < 0.01) compared with the self-executed control condition. Compared with optimized posture with independent reach, facilitated movement again produced similar reductions in MD and triceps activity, with decreased LT activity also noted ( < 0.01). Lower activity levels were noted during facilitation than during manual guidance, with or without optimized posture, in the UT, MT, ( < 0.01), SA, and MD muscles ( < 0.05). Triceps facilitation did not increase scapular stability activity, but the activity levels in several other muscle groups (SA, MD, and triceps) were reduced during triceps facilitation compared with optimized posture or guided movement. Detailed analysis of this technique, including co-registered kinematic data and timing of muscle onset, is needed.
神经发育技术常用于上肢康复，但几乎没有证据支持与这一概念相关的促进技术。这项探索性研究确定，与自主选择的姿势和伸展相比，在健康参与者伸展过程中，肱三头肌的促进技术是否会影响肩胛胸壁肌肉的活动。次要目的是确定促进技术与优化姿势或引导运动之间的肌肉激活水平是否存在差异。我们还假设，在促进运动过程中，肩胛稳定肌（下斜方肌[LT]和前锯肌[SA]）的活动将比其他条件下增加。该研究纳入了17名健康参与者（年龄20 - 70岁）。表面肌电图记录了在五种运动条件下，斜方肌上束（UT）、斜方肌中束（MT）、LT肌以及SA、三角肌中束（MD）和肱三头肌的肌肉活动。我们使用Friedman检验来探索不同条件下肌肉活动的差异，并使用Bonferroni事后检验来探索不同条件之间的差异。与自主执行的对照条件相比，促进技术使SA、MD和肱三头肌的活动减少（<0.01）。与独立伸展的优化姿势相比，促进运动再次使MD和肱三头肌的活动出现类似程度的降低，同时LT活动也减少（<0.01）。在有或没有优化姿势的情况下，与手动引导相比，促进过程中UT、MT（<0.01）、SA和MD肌肉的活动水平较低（<0.05）。肱三头肌促进并未增加肩胛稳定性活动，但与优化姿势或引导运动相比，在肱三头肌促进过程中，其他几个肌肉群（SA、MD和肱三头肌）的活动水平降低。需要对该技术进行详细分析，包括共同记录的运动学数据和肌肉起始时间。
