文章摘要
陈彦,吴霜,王志涛,田新原,裴强.表面肌电联合等速肌力测试用于不完全腰髓损伤患者的精准评估研究[J].中国康复,2018,33(1):15-18
表面肌电联合等速肌力测试用于不完全腰髓损伤患者的精准评估研究
Surface electromyography combined with isokinetic muscle test for accurate evaluation of patients with incomplete lumbar spinal cord injury
  
DOI:
中文关键词: 不完全性脊髓损伤  表面肌电  等速肌力测试  肌力  肌耐力  精准评估
英文关键词: incomplete spinal cord injury  surface electromyography  isokinetic muscle strength testing  muscle strength  muscle endurance  accurate evaluation
基金项目:贵州省科技计划项目(黔科合同LG字【2012】037号);贵州省卫生厅科学技术基金项目(gzwkj2011-1-103)
作者单位
陈彦 贵州医科大学附属医院康复医学科贵阳 550004 
吴霜 贵州医科大学附属医院康复医学科贵阳 550004 
王志涛 贵州医科大学附属医院康复医学科贵阳 550004 
田新原 贵州医科大学附属医院康复医学科贵阳 550004 
裴强 贵州医科大学附属医院康复医学科贵阳 550004 
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中文摘要:
      目的:研究表面肌电测试联合等速肌力评估用于不完全腰髓损伤患者康复治疗的精准量化评估。方法:60例腰髓不完全损伤患者,随机分为观察组(常规康复+等速肌力训练)和对照组(常规康复训练),每组各30例。在治疗前和治疗3个月后对2组患者进行膝关节肌群徒手肌力评定(MMT)、等速肌力测试[峰力矩(PT)、峰力矩/体重比(PT/BW)、等速耐力比(RO)]和表面肌电测试,包括股直肌和股二头肌的肌电积分值(iEMG)和平均功率频率(MPF)。结果:治疗3个月后,2组患者腘绳肌峰力矩体重比(H-PT/BW)、股四头肌峰力矩体重比(Q-PT/BW)、股二头肌肌电积分值(BF-iEMG)、股直肌肌电积分值(RF-iEMG)、腘绳肌耐力比(H-RO)、股四头肌耐力比(Q-RO)均较治疗前明显提高(均P<0.01,0.05),且观察组高于对照组(均P<0.01)。2组股二头肌平均功率频率(BF-MPF)和股直肌平均功率频率(RF-MPF)均较治疗前明显降低(均P<0.05),且观察组低于对照组(均P<0.05)。2组股四头肌徒手肌力分级(H-MMT)、腘绳肌徒手肌力分级(Q-MMT)均较治疗前明显提高(均P<0.05),但2组间比较差异无统计学意义。结论:表面肌电测试联合等速肌力评估较传统的徒手肌力测试能精准量化不完全腰髓损伤患者康复治疗后下肢肌力和肌耐力的改变,可以作为这类患者的康复评估方法的补充。
英文摘要:
      Objective: To evaluate the accuracy of surface electromyography combined with isokinetic muscle test for patients with incomplete lumbar spinal cord injury. 〖WT5"HZ〗Methods〖WT5"BZ〗: Sixty patients with incomplete lumbar spinal cord injury were recruited, and randomly divided into control group and observation group. Patients in both groups were treated with the conventional rehabilitation therapy, and those in the observation group accepted isokinetic muscle strength training additionally. The manual muscle testing (MMT) and isokinetic muscle strength testing of knee muscles including peak torque (PT), peak torque to body weight ratio (PT/BW) and endurance ratio (RO) were evaluated before and after the treatment. The integrated electromyogram (iEMG) of rectus femoris and biceps femoris and the mean power frequency (MPF) were also evaluated. Results: After the treatment for three months, the PT/BW of hamstring (H-PT/BW), PT/BW of quadriceps femoris (Q-PT/BW), iEMG of biceps femoris (BF-iEMG), iEMG of rectus femoris (RF-iEMG), RO of hamstring (H-RO), and RO of quadriceps femoris (Q-RO) were significantly increased as compared with those before the treatment (P<0.01,0.05), and those in the observation group were significantly higher than in the control group (P<0.01). The BF-MPF and RF-MPF were decreased after the treatment in both groups (P<0.05), and those in the observation group were significantly lower than in the control group (P<0.05). Although the MMT of hamstring (H-MMT) and MMT of quadriceps femoris (Q-MMT) were increased in both groups after the treatment (P<0.05), there was no significant difference between those two groups. Conclusion: Compared to the traditional manual muscle strength testing, sEMG and isokinetic muscle test could accurately quantify the changes of lower limb muscle strength and muscular endurance after rehabilitation treatment in patients with lumbar spinal cord injury, which could be used as a supplement to the rehabilitation assessment methods for such patients.
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