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矫形器对步态中肌肉活动和协同作用的影响。

Effects of orthoses on muscle activity and synergy during gait.

机构信息

Department of Physical Therapy, Faculty of Rehabilitation, Gunma PAZ University, Takasaki-shi, Gunma, Japan.

Department of Speech-Language-Hearing Therapy, Faculty of Rehabilitation, Gunma PAZ University, Takasaki-shi, Gunma, Japan.

出版信息

PLoS One. 2023 Feb 9;18(2):e0281541. doi: 10.1371/journal.pone.0281541. eCollection 2023.

Abstract

An orthosis is often used in rehabilitation to improve kinetic and kinematic parameters during gait. However, whether changes in neural control depend on wearing an orthosis during gait is unclear. We measured the muscle activity and synergy of the lower limb muscles without orthosis and with two types of orthoses: ankle-foot orthosis (AFO) and knee-ankle-foot orthosis (KAFO). Muscle activity during gait was measured in 15 healthy adults, and muscle synergies were extracted using non-negative matrix factorization. The results revealed that some muscle activities were significantly different among the three conditions. Post-hoc analysis indicated differences between each condition. Knee extensor muscle activity related to the loading response was significantly increased by wearing the AFO. In the KAFO condition, hip abductor muscle activity related to weight bearing was significantly decreased, and ankle dorsiflexor muscle activity was increased to secure clearance during the swing phase. However, the number of muscle synergies and complexity of muscle synergy did not significantly change among these conditions. However, along with changes in muscle activity, the activation pattern and weightings of muscle synergies tended to change with the use of orthoses. Each muscle activity was changed by wearing the orthosis; however, the immediate mechanical constraint did not change the framework of muscle synergy.

摘要

矫形器常用于康复治疗中,以改善步态中的运动学和运动学参数。然而,佩戴矫形器是否会改变神经控制尚不清楚。我们测量了在不佩戴矫形器和佩戴两种矫形器(踝足矫形器(AFO)和膝踝足矫形器(KAFO))的情况下,下肢肌肉的肌肉活动和协同作用。在 15 名健康成年人中测量了步态中的肌肉活动,并使用非负矩阵分解提取肌肉协同作用。结果表明,三种情况下的一些肌肉活动存在显著差异。事后分析表明,每个条件之间都存在差异。佩戴 AFO 后,与负重反应相关的膝关节伸肌肌肉活动明显增加。在 KAFO 条件下,与承重相关的髋关节外展肌肌肉活动明显减少,为确保摆动阶段的间隙,踝关节背屈肌肌肉活动增加。然而,这些情况下的肌肉协同作用数量和复杂性并没有显著变化。然而,随着肌肉活动的变化,肌肉协同作用的激活模式和权重往往会随着矫形器的使用而改变。佩戴矫形器会改变每个肌肉的活动;然而,即时的机械约束并没有改变肌肉协同作用的框架。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1779/9910715/80ea74c192d0/pone.0281541.g001.jpg

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