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从肩胛稳定肌的预期肌肉激活观察青少年特发性脊柱侧弯中的神经肌肉紊乱:一项横断面研究。

Neuromuscular disturbances in adolescent idiopathic scoliosis observed from the anticipatory muscle activations in scapula stabilizers: a cross-sectional study.

作者信息

Wang Yu, Xia Nan, Gu Minghui, Chen Zejian, Xu Jiang, Wang Li, Liao Yi, Xie Lingfeng, Huang Xiaolin

机构信息

Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, People's Republic of China.

World Health Organization Cooperating Centre for Training and Research in Rehabilitation, Wuhan, Hubei Province, People's Republic of China.

出版信息

BMC Musculoskelet Disord. 2024 Dec 19;25(1):1019. doi: 10.1186/s12891-024-08137-y.

Abstract

BACKGROUND

While it is well-stablished that scoliosis can lead to neuromuscular control disorders, the specific characteristics of these impairments remain unclear. This study aimed to explore the neuromuscular features of scapula stabilizers in adolescents with idiopathic scoliosis (AIS) through an analysis of anticipatory muscle activations (AMAs).

METHODS

A cross-sectional observational study was conducted with 17 AIS and 19 age-matched healthy subjects. Both the AIS and healthy groups performed right and left upper limb reaching tasks at three different heights while surface electromyography monitored the activity of scapular stabilizers. The muscles examined included the bilateral infraspinatus, upper trapezius, lower trapezius, serratus anterior, latissimus dorsi and the anterior deltoid. The incidence, onset latencies, and amplitude of AMAs were compared between the AIS and healthy groups.

RESULTS

Among scapular stabilizers, ipsilateral upper trapezius (iUT) and ipsilateral infraspinatus (iIS) exhibited the highest AMAs incidence at 72.59% and 70.06%, respectively. However, AMAs incidence significantly declined on the concave side of the thoracic curve in AIS group, particularly in iUT (55.63 ± 14.74 vs. 45.21 ± 19.92, t = 2.330, P = 0.034) and iIS (59.38 ± 20.16 vs. 48.13 ± 22.11, t = 2.316, P = 0.035). Regarding onset latencies, the AIS group exhibited delayed activation of ipsilateral lower trapezius (F = 3.586, P < 0.05, η = 0.006) and advanced activation of contralateral upper trapezius (F = 7.753, P < 0.001, η = 0.027) and contralateral infraspinatus (F = 6.554, P < 0.01, η = 0.024) on concave side compared to the healthy group. Additionally, almost all scapula stabilizers in AIS group exhibited reduction of AMAs amplitude compared to the healthy group.

CONCLUSIONS

This preliminary study suggests potential neuromotor control impairments in the AIS population, as indicated by observed trends in the incidence, amplitude, and timing of AMAs in scapular stabilizers. These preliminary insights may inform the design of future rehabilitation interventions, with attention to neurodevelopmental needs during adolescence.

TRIAL REGISTRATION NUMBER

ChiCTR2300075167, Date: 2023-08-28.

摘要

背景

虽然脊柱侧弯可导致神经肌肉控制障碍已得到充分证实,但这些损伤的具体特征仍不清楚。本研究旨在通过分析预期肌肉激活(AMA)来探索特发性脊柱侧弯(AIS)青少年肩胛骨稳定肌的神经肌肉特征。

方法

对17例AIS患者和19例年龄匹配的健康受试者进行了一项横断面观察性研究。AIS组和健康组在三个不同高度进行右上肢和左上肢伸展任务,同时表面肌电图监测肩胛骨稳定肌的活动。检测的肌肉包括双侧冈下肌、上斜方肌、下斜方肌、前锯肌、背阔肌和三角肌前部。比较AIS组和健康组AMA的发生率、起始潜伏期和幅度。

结果

在肩胛骨稳定肌中,同侧上斜方肌(iUT)和同侧冈下肌(iIS)的AMA发生率最高,分别为72.59%和70.06%。然而,AIS组胸椎曲线凹侧的AMA发生率显著下降,尤其是iUT(55.63±14.74 vs. 45.21±19.92,t = 2.330,P = 0.034)和iIS(59.38±20.16 vs. 48.13±22.11,t = 2.316,P = 0.035)。关于起始潜伏期,与健康组相比,AIS组凹侧同侧下斜方肌激活延迟(F = 3.586,P < 0.05,η = 0.006),对侧上斜方肌(F = 7.753,P < 0.001,η = 0.027)和对侧冈下肌(F = 6.554,P < 0.01,η = 0.024)激活提前。此外,与健康组相比,AIS组几乎所有肩胛骨稳定肌的AMA幅度均降低。

结论

这项初步研究表明,AIS人群中存在潜在的神经运动控制障碍,这在肩胛骨稳定肌AMA的发生率、幅度和时间趋势中有所体现。这些初步见解可能为未来康复干预的设计提供参考,同时关注青少年时期的神经发育需求。

试验注册号

ChiCTR2300075167,日期:2023年8月28日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4916/11660600/00227dd68dca/12891_2024_8137_Fig1_HTML.jpg

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