Molina-Rueda Francisco, Fernández-Vázquez Diego, Navarro-López Víctor, López-González Raúl, Carratalá-Tejada María
Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine Department, Faculty of Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain.
Movement Analysis, Biomechanics, Ergonomics, and Motor Control Laboratory, Faculty of Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain.
Diagnostics (Basel). 2023 Jun 26;13(13):2169. doi: 10.3390/diagnostics13132169.
Multiple sclerosis (MS) is a progressive neurodegenerative disease characterized by axonal degeneration and demyelination. Changes in gait, related to joint kinematics and kinetics, especially at the ankle and knee, have been observed in people with MS (pwMS). Muscle coactivation plays an important role in joint stabilization; however, excessive coactivation may interfere with gait. The aim of this study was to analyze the differences in muscle activation during gait in pwMS compared to healthy individuals.
A cross-sectional study was conducted involving pwMS and healthy controls. Surface electromyography was used to record muscle activity during gait. The main outcome measures were the coactivation index (CI) and the area under the curve (AUC), which were calculated for several pairs of lower extremity muscles.
Nine pwMS and nine healthy controls were included. When comparing the MS group to the control group, the AUC was significantly higher in the lateral gastrocnemius ( = 0.023) and the CI for the lateral gastrocnemius-anterior tibialis ( = 0.022) and gluteus maximus-lateral gastrocnemius ( = 0.047).
Mildly affected pwMS have altered muscle coactivation patterns during gait, especially in the most affected limb. The results highlight the importance of muscle coactivation in pwMS and its possible role in the early detection of gait abnormalities.
多发性硬化症（MS）是一种以轴突变性和脱髓鞘为特征的进行性神经退行性疾病。在多发性硬化症患者（pwMS）中已观察到与关节运动学和动力学相关的步态变化，尤其是在踝关节和膝关节处。肌肉共同激活在关节稳定中起重要作用；然而，过度的共同激活可能会干扰步态。本研究的目的是分析pwMS与健康个体在步态期间肌肉激活的差异。
进行了一项横断面研究，纳入了pwMS患者和健康对照者。使用表面肌电图记录步态期间的肌肉活动。主要结局指标是共同激活指数（CI）和曲线下面积（AUC），针对几对下肢肌肉进行计算。
纳入了9名pwMS患者和9名健康对照者。将MS组与对照组进行比较时，外侧腓肠肌的AUC显著更高（P = 0.023），外侧腓肠肌 - 胫骨前肌的CI（P = 0.022）以及臀大肌 - 外侧腓肠肌的CI（P = 0.047）。
轻度受影响的pwMS患者在步态期间肌肉共同激活模式发生改变，尤其是在受影响最严重的肢体中。结果突出了肌肉共同激活在pwMS中的重要性及其在步态异常早期检测中的可能作用。
