王美华,张天宇,李婷婷,等.帕金森病患者躯干肌表面肌电活动特征分析[J].中华物理医学与康复杂志,2019,41(4):283-286
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| 帕金森病患者躯干肌表面肌电活动特征分析 |
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| DOI：DOI:10.3760/cma.j.issn.0254-1424.2019.04.010 |
| 中文关键词: 帕金森病 躯干肌 表面肌电 |
| 英文关键词: Parkinson′s disease Trunk muscles Surface electromyography |
| 基金项目:国家重点研发计划（2018YFC1314700）；国家自然科学基金（81572234）；上海市教育委员会曙光计划（14SG21）；上海市市级医疗卫生优秀学科带头人培养计划（2017BR029） |
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| 中文摘要: |
| 目的 通过分析帕金森病患者与正常对照者躯干肌表面肌电活动差异以及不同严重程度帕金森病患者躯干肌表面肌电活动差异，探讨帕金森病患者躯干肌肌电活动特征及姿势异常疾病基础。 方法 本研究选取帕金森病患者19例作为研究对象，同时招募8例健康志愿者作为正常对照。采用16导联表面肌电仪器采集研究对象在平躺、站立、行走3种姿势下双侧胸竖脊肌、腰竖脊肌、腹外斜肌及腹直肌表面肌电振幅均值。 结果 平躺时帕金森病组腰竖脊肌表面肌电振幅［（18.56±14.57）μV］和腹直肌表面肌电振幅［（24.00±18.80）μV］均较对照组明显增加（P<0.05）；站立时帕金森病组腹外斜肌表面肌电振幅［（27.87±11.49）μV］较对照组明显增加（P<0.05）；行走时帕金森病组胸竖脊肌表面肌电振幅［（58.74±29.69）μV］和腹外斜肌表面肌电振幅［（59.01±25.20）μV］均较对照组明显增加（P<0.05）。H-Y分级1~1.5级帕金森病患者仅行走时腹直肌表面肌电振幅［（55.42±12.34）μV）］较对照组明显增加（P<0.05）；H-Y分级2~3级帕金森病患者在3种姿势下均有1组或多组躯干肌表面肌电振幅较对照组明显增加（P<0.05）。 结论 帕金森病患者躯干伸肌及屈肌肌电活动均较正常人同时增多，且疾病程度越严重患者躯干肌受累范围越广泛；本研究为帕金森病早期个体化康复及肉毒毒素注射靶肌选择提供神经电生理依据。 |
| 英文摘要: |
| Objective To explore the characteristics of trunk muscle activity in persons with Parkinson′s disease (PD) in search of better treatments for abnormal posture. Methods Ninety persons with PD of different severity and 8 normal controls were studied using surface electromyography (sEMG). A sixteen-lead sEMG instrument was used to collect sEMG amplitudes from the bilateral thoracic erector spinae, lumbar erector spinae, external oblique and rectus abdominis muscles when the subjects were lying, standing and walking. Results Compared with the control group, a significant increase was observed in the sEMG amplitude of the lumbar erector spinal muscle ［(18.56±14.57)μV］ and rectus abdominis muscles ［(24.00±18.80)μV］ of the PD group when lying. Significant relative increases in (P<0.05), of the external oblique muscles were observed ［(27.87±11.49)μV］ when standing (P<0.05), and in the thoracic erector spinae muscle ［(58.74±29.69)μV］ and external oblique muscles ［(59.01±25.20)μV］ increased when walking (P<0.05). Compared with the control group, the sEMG activity of the external oblique muscles was significantly elevated in PD patients at Hoehn and Yahr stage 1 to 1.5 when walking. One or more of the trunk muscle groups showed significantly greater activity in the PD patients in Hoehn and Yahr stage 2 or 3 in all three positions. Conclusions The sEMG activities of the extensor and flexor muscles increase simultaneously in PD patients. More trunk muscles are involved in PD patients with higher H-Y grades. These findings provide a neurophysiological basis for the customizaton of rehabilitation therapy for patients with Parkinson′s disease and for the precise selection of muscles for botulinum toxin injection. |
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