表面肌电图动态网络指标在网状神经肌肉控制评估中的临床意义。

Clinical significance of dynamical network indices of surface electromyography for reticular neuromuscular control assessment.

机构信息

Department of Rehabilitation Medicine, Suzhou Municipal Hospital, Gusu School, Affiliated Suzhou Hospital of Nanjing Medical University, Nanjing Medical University, Suzhou, 215000, China.

Department of Medical Engineering, Suzhou Municipal Hospital, Gusu School, Affiliated Suzhou Hospital of Nanjing Medical University, Nanjing Medical University, Suzhou, 215000, China.

出版信息

J Neuroeng Rehabil. 2023 Dec 20;20(1):170. doi: 10.1186/s12984-023-01297-3.

DOI:10.1186/s12984-023-01297-3

PMID:38124144

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10734060/

Abstract

BACKGROUND

There is currently no objective and accurate clinical assessment of reticular neuromuscular control in healthy subjects or patients with upper motor neuron injury. As a result, clinical dysfunctions of neuromuscular control could just be semi-quantified, efficacies and mechanisms of various therapies for neuromuscular control improving are difficult to verify.

METHODS

Fourteen healthy participants were required to maintain standing balance in the kinetostatics model of Gusu Constraint Standing Training (GCST). A backward and upward constraint force was applied to their trunk at 0°, 20° and 25°, respectively. The multiplex recurrence network (MRN) was applied to analyze the surface electromyography signals of 16 muscles of bilateral lower limbs during the tests. Different levels of MRN network indices were utilized to assess reticular neuromuscular control.

RESULTS

Compared with the 0° test, the MRN indices related to muscle coordination of bilateral lower limbs, of unilateral lower limb and of inter limbs showed significant increase when participants stood in 20° and 25° tests (P < 0.05). The indices related to muscle contribution of gluteal, anterior thigh and calf muscles significantly increased when participants stood in 20° and 25° tests (P < 0.05).

CONCLUSIONS

This study applied the dynamical network indices of MRN to analyze the changes of neuromuscular control of lower limbs of healthy participants in the kinetostatics model of GCST. Results showed that the overall coordination of lower limb muscles would be significantly enhanced during performing GCST, partly by the enhancement of neuromuscular control of single lower limb, and partly by the enhancement of joint control across lower limbs. In particular, the muscles in buttocks, anterior thighs and calves played a more important role in the overall coordination, and their involvement was significantly increased. The MRN could provide details of control at the bilateral lower limbs, unilateral lower limb, inter limbs, and single muscle levels, and has the potential to be a new tool for assessing the reticular neuromuscular control. Trial registration ChiCTR2100055090.

摘要

背景

目前，对于健康受试者或上运动神经元损伤患者，尚缺乏对网状神经肌肉控制的客观、准确的临床评估。因此，神经肌肉控制的临床功能只能进行半定量评估，各种神经肌肉控制改善治疗的疗效和机制也难以验证。

方法

14 名健康受试者需在姑苏约束站立训练（GCST）的静力学模型中保持站立平衡。分别在 0°、20°和 25°时，向受试者的躯干施加向后和向上的约束力。应用多重递归网络（MRN）分析测试中双侧下肢 16 块肌肉的表面肌电信号。采用不同水平的 MRN 网络指标评估网状神经肌肉控制。

结果

与 0°测试相比，当受试者处于 20°和 25°测试时，双侧下肢、单侧下肢和肢体间的肌肉协调性相关的 MRN 指数显著增加（P<0.05）。当受试者处于 20°和 25°测试时，臀肌、股前肌和小腿肌的肌肉贡献相关指数显著增加（P<0.05）。

结论

本研究应用 MRN 的动力学网络指标分析了 GCST 静力学模型中健康受试者下肢神经肌肉控制的变化。结果表明，在进行 GCST 时，下肢肌肉的整体协调性会显著增强，这部分是通过单一下肢的神经肌肉控制增强，部分是通过下肢关节控制增强。特别是臀部、股前肌和小腿肌肉在整体协调中发挥了更重要的作用，其参与度显著增加。MRN 可以提供双侧下肢、单侧下肢、肢体间和单块肌肉水平的控制细节，有可能成为评估网状神经肌肉控制的新工具。