Ferreira Cintia Lopes, Oliveira Barroso Filipe, Torricelli Diego, Pons José L, Politti Fabiano, Lucareli Paulo Roberto Garcia
Department of Rehabilitation Science, Human Motion Analysis Laboratory, Universidade Nove de Julho, São Paulo, Brazil.
Neural Rehabilitation Group, Cajal Institute, Spanish National Research Council (CSIC), Madrid, Spain.
PLoS One. 2023 Oct 5;18(10):e0292464. doi: 10.1371/journal.pone.0292464. eCollection 2023.
Several studies suggest that the central nervous system coordinates muscle activation by modulating neural commands directed to groups of muscles combined to form muscle synergies. Individuals with patellofemoral pain (PFP) move differently from asymptomatic individuals. Understanding the neural strategies involved in the execution of tasks such as walking can help comprehend how the movement is planned and better understand this clinical condition. The objective of this study was to compare muscle synergies between women with and without PFP during walking. Eleven women with PFP and thirteen asymptomatic women were assessed using three-dimensional kinematics and electromyography (EMG) while walking at self-selected speed. Kinematics of the trunk, pelvis and lower limbs were analyzed through the Movement Deviation Profile. Muscle synergies were extracted from the EMG signals of eight lower limb muscles collected throughout the whole gait cycle. Kinematic differences between the two groups (p<0.001, z-score = 3.06) were more evident during loading response, terminal stance, and pre-swing. PFP group presented a lower number of muscle synergies (p = 0.037), and greater variability accounted for (VAFtotal) when using 3 (p = 0.017), 4 (p = 0.004), and 5 (p = 0.012) synergies to reconstruct all EMG signals. The PFP group also presented higher VAFmuscle for rectus femoris (p = 0.048) and gastrocnemius medialis (p = 0.019) when considering 4 synergies. Our results suggest that women with PFP show lower motor complexity and deficit in muscle coordination to execute gait, indicating that gait in PFP is the result of different neural commands compared to asymptomatic women.
多项研究表明，中枢神经系统通过调节导向组合形成肌肉协同作用的肌群的神经指令来协调肌肉激活。髌股疼痛（PFP）患者的运动方式与无症状个体不同。了解诸如行走等任务执行过程中涉及的神经策略有助于理解运动是如何规划的，并更好地理解这种临床状况。本研究的目的是比较患有和未患有PFP的女性在行走过程中的肌肉协同作用。11名患有PFP的女性和13名无症状女性在以自我选择的速度行走时，使用三维运动学和肌电图（EMG）进行评估。通过运动偏差剖面分析躯干、骨盆和下肢的运动学。从整个步态周期收集的八块下肢肌肉的EMG信号中提取肌肉协同作用。两组之间的运动学差异（p<0.001，z分数 = 3.06）在负重反应、终末站立和摆动前期更为明显。PFP组的肌肉协同作用数量较少（p = 0.037），当使用3种（p = 0.017）、4种（p = 0.004）和5种（p = 0.012）协同作用来重建所有EMG信号时，其解释的变异性（VAFtotal）更大。在考虑4种协同作用时，PFP组的股直肌（p = 0.048）和腓肠肌内侧头（p = 0.019）的VAFmuscle也更高。我们的结果表明，患有PFP的女性在执行步态时表现出较低的运动复杂性和肌肉协调性缺陷，这表明与无症状女性相比，PFP患者的步态是不同神经指令的结果。
