Hiranaka T, Takeuchi K
Department of Orthopaedic Surgery, Shinnittetsu Corp. Hirohata Works Hospital, Hyogo, Japan.
Nihon Seikeigeka Gakkai Zasshi. 1995 Sep;69(9):675-84.
An evaluation of the muscular functions of the vastus medialis, vastus lateralis, rectus femoris, medial hamstring, and of the lateral hamstring was performed using electromyography in 33 knees of 26 female patients with osteoarthritis (OA group) and in 25 knees of 19 healthy female volunteers (control group). During standing on both feet, all muscles in the OA group showed higher IEMG (integrated electromyography) and higher LMR (IEMG of vastus lateralis/IEMG of vastus medialis ratio in the quadriceps; and lateral hamstring/medial hamstring ratio in the hamstrings) than the control group. These augmentary muscular activities ameliorated the varus deformity caused by the osteoarthritis. During maximum isometric voluntary contraction, the OA group showed lower extension and flexion torque of the knees and also lower IEMG than to the control group, while the IEMG of vastus lateralis was not lower. These findings indicated decreased muscular activities in the osteoarthritic knee, and that the activity of the quadriceps was maintained mainly by the vastus lateralis under such conditions. Frequency analysis of the myoelectric signal during maximum isometric voluntary contraction revealed a single peak of low frequency in the power spectrum density function of the quadriceps and double peaks of low and of high frequency in the hamstring. In the OA group, the peak height of the low frequency component was increased in the quadriceps and decreased in the hamstring. We concluded that the duration of the motor unit action potentials was affected in the osteoarthritic knee.
在26例患骨关节炎的女性患者的33个膝关节(骨关节炎组)和19名健康女性志愿者的25个膝关节(对照组)中,使用肌电图对股内侧肌、股外侧肌、股直肌、半腱肌内侧头和半腱肌外侧头的肌肉功能进行了评估。在双脚站立时,骨关节炎组的所有肌肉均显示出比对照组更高的积分肌电图(IEMG)和更高的左右肌电图比值(股四头肌中股外侧肌IEMG与股内侧肌IEMG的比值;以及腘绳肌中外侧腘绳肌与内侧腘绳肌的比值)。这些增强的肌肉活动改善了骨关节炎引起的膝内翻畸形。在最大等长自主收缩期间,骨关节炎组膝关节的伸展和屈曲扭矩较低,IEMG也低于对照组,而股外侧肌的IEMG并不低。这些发现表明骨关节炎膝关节的肌肉活动减少,并且在这种情况下股四头肌的活动主要由股外侧肌维持。对最大等长自主收缩期间肌电信号的频率分析显示,股四头肌的功率谱密度函数中有一个低频单峰,腘绳肌中有低频和高频双峰。在骨关节炎组中,股四头肌低频成分的峰值高度增加,腘绳肌中则降低。我们得出结论,骨关节炎膝关节中运动单位动作电位的持续时间受到影响。