School of Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland.
School of Engineering, Zurich University of Applied Sciences, Winterthur, Switzerland.
PLoS One. 2022 Jul 29;17(7):e0272382. doi: 10.1371/journal.pone.0272382. eCollection 2022.
The aim of this study was to explore differences in trunk muscle activity on a stable and mobile seat for people after stroke and healthy participants. Trunk control exercises are known to have a beneficial effect on trunk control, balance, and mobility after stroke. The effect of such exercises could be enhanced by the use of a mobile seat to provide further training stimuli. However, little research on the musculoskeletal effects of trunk training on mobile seats has been carried out. On a stable and a mobile seat, thirteen people after stroke and fifteen healthy participants performed two selective trunk control exercises, which were lateral flexion initiated by the pelvis and the thorax. The maximal surface electromyography relative to static sitting of the muscles multifidus, erector spinae, and obliquus externus was recorded bilaterally. The effects of group, seat condition, trunk control exercise, and muscle side were investigated employing within-subject linear-mixed-models. Compared to the stable seat, the maximal muscle activity of people after stroke on the mobile seat was higher during the thorax-initiated exercise and lower during the pelvis-initiated exercise. Healthy participants showed opposite results with higher muscle activity on the mobile seat during the pelvis-initiated exercise. For trunk control training on a mobile seat with high muscle activation people after stroke should perform trunk control exercises initiated by the thorax, for training with lower muscle activity people after stroke should initiate selective trunk movements by the pelvis. The results can support the planning of progressive trunk control rehabilitation programs.
本研究旨在探讨稳定和移动座椅上，脑卒中患者和健康参与者的躯干肌肉活动差异。众所周知，躯干控制练习对脑卒中后躯干控制、平衡和活动能力有有益影响。使用移动座椅提供进一步的训练刺激，可以增强此类练习的效果。然而，对于在移动座椅上进行躯干训练的肌肉骨骼影响的研究甚少。在稳定座椅和移动座椅上，13 名脑卒中患者和 15 名健康参与者进行了两种选择性躯干控制练习，分别为骨盆启动的侧屈和胸廓启动的侧屈。双侧记录多裂肌、竖脊肌和外斜肌相对于静态坐姿的最大表面肌电图。采用受试者内线性混合模型研究了组、座椅条件、躯干控制运动和肌肉侧的影响。与稳定座椅相比，移动座椅上脑卒中患者的最大肌肉活动在胸廓启动练习时较高，而在骨盆启动练习时较低。健康参与者的结果则相反，在骨盆启动练习时移动座椅上的肌肉活动较高。对于高肌肉激活的移动座椅上的躯干控制训练，脑卒中患者应进行胸廓启动的躯干控制练习，对于低肌肉活动的训练，脑卒中患者应通过骨盆启动选择性躯干运动。研究结果可以支持规划渐进式躯干控制康复计划。
