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脑瘫患儿步态中的共同收缩和相位活动。

Cocontraction and phasic activity during GAIT in children with cerebral palsy.

作者信息

Unnithan V B, Dowling J J, Frost G, Volpe Ayub B, Bar-Or O

机构信息

Children's Exercise and Nutrition Centre, McMaster University, Hamilton, Ontario, Canada.

出版信息

Electromyogr Clin Neurophysiol. 1996 Dec;36(8):487-94.

PMID:8985677
Abstract

Simultaneous activity of agonist and antagonistic muscles during a task is known as cocontraction. The primary aim of the present study was to use a cocontraction index (CI) to quantify differences in EMG activity between a group of CP and control children at two different walking speeds. The secondary aim was to compare the amount of time the muscles were activated ("on" thresholds) between the groups. Seventeen subjects volunteered for the study. One group consisted of 9 (7M, 2F) children with CP (age 12.7 +/- 2.8 years, mean +/- SD). The second group consisted of 8 able-bodied controls (7M, 1F). The discontinuous submaximal treadmill walking protocol had two 4min stages at 0% gradient. Speeds selected were 3 km.h-1 and 90% of the pre-determined fastest walking speed (FWS). Two sites of CI were measured from the EMGs of tibialis anterior and soleus (leg) and vastus lateralis and hamstrings (thigh). Significantly (p < 0.05) higher CI values were noted for the CP subjects compared to the controls, irrespective of speed or cocontraction site and there was a significant (p < 0.05) increase in CI values with increased walking speed for both CP and control subjects. Phasic analyses for 5% max EMG and 10% max EMG "on" thresholds demonstrated significant (p < 0.05) main effects for group (CP subjects had a longer time period of muscle activation than controls) and speed (muscles were active longer at 90% FWS than 3 km.h-1). The precise mechanisms by which cocontraction contributes toward abnormal gait and wasted mechanical energy require further research incorporating both electromyographic and kinematic analysis.

摘要

在一项任务中,主动肌和拮抗肌同时活动被称为共同收缩。本研究的主要目的是使用共同收缩指数(CI)来量化一组脑性瘫痪(CP)儿童和对照组儿童在两种不同步行速度下肌电图(EMG)活动的差异。次要目的是比较两组之间肌肉激活的时间量(“开启”阈值)。17名受试者自愿参加了这项研究。一组由9名(7名男性,2名女性)CP儿童组成(年龄12.7±2.8岁,平均±标准差)。第二组由8名健全对照组(7名男性,1名女性)组成。不连续次最大强度跑步机步行方案在0%坡度下有两个4分钟阶段。选择的速度为3 km/h和预先确定的最快步行速度(FWS)的90%。从胫前肌和比目鱼肌(腿部)以及股外侧肌和腘绳肌(大腿)的肌电图中测量两个CI部位。与对照组相比,CP受试者的CI值显著更高(p<0.05),无论速度或共同收缩部位如何,并且CP和对照组受试者的CI值均随着步行速度的增加而显著增加(p<0.05)。对5%最大肌电图和10%最大肌电图“开启”阈值的相位分析表明,组间存在显著的(p<0.05)主效应(CP受试者的肌肉激活时间比对照组更长)和速度效应(在90%FWS时肌肉的激活时间比3 km/h时更长)。共同收缩导致异常步态和机械能浪费的确切机制需要结合肌电图和运动学分析进行进一步研究。

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