| 李柯蓉,谢登玄,林姝涵,赵智,王玮,孟繁媛.青少年特发性脊柱侧凸患者躯干屈伸时椎旁肌表面肌电和运动功能的特征观察[J].中国康复,2025,40(2):72-77 |
| 青少年特发性脊柱侧凸患者躯干屈伸时椎旁肌表面肌电和运动功能的特征观察 |
| Characteristics of paravertebral surface electromyography and motor function during trunk flexion and extension in adolescent patients with idiopathic scoliosis |
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| DOI：10.3870/zgkf.2025.02.002 |
| 中文关键词: 青少年特发性脊柱侧凸 表面肌电 躯干腰背肌 运动功能 |
| 英文关键词: adolescent idiopathic scoliosis surface myoelectricity lumbodorsal muscles of trunk motor function |
| 基金项目:国家自然科学基金（62103405）；云南省科技厅-昆明医科大学应用基础研究联合专项（202201AY070001-014）；广东省基础与应用基础研究基金（2022A1515010169）；深圳市医学研究专项资金（A2302026） |
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| 中文摘要: |
| 目的：研究青少年特发性脊柱侧凸（AIS）患者与健康人群腰背肌和运动功能的差别，为临床AIS患者康复评估和干预治疗提供理论依据。方法：收录27例腰弯为主弯的S型AIS患者为AIS组，招募30例健康同龄人为健康组。使用表面肌电测试躯干屈曲和后伸时脊柱椎旁肌和腹肌的激活；躯干屈伸肌力及肌耐力测试评估受试者核心稳定；使用功能性动作筛查（FMS）评估运动功能并筛查运动损伤的风险。结果：在躯干屈曲和后伸测试中，AIS患者的顶椎和上下端椎凸侧椎旁肌的肌电均方根值（RMS）显著大于凹侧（P<0.05，0.01），但凸凹侧腹直肌的RMS值差异无统计学意义。AIS组顶椎和上下端椎凸凹侧椎旁肌RMS比值＞1，健康组双侧椎旁肌RMS比值接近1，且2组除腹肌以外其他项目AIS组均大于健康组（P<0.05，0.01）。AIS患者相比健康组躯干屈伸肌力和肌耐力均下降（P<0.05，0.01）。FMS评估中AIS组总分低于健康组（P<0.05，0.01），动作细分中除了FMS-1分数小于健康组（P<0.01），其他6个FMS动作2组差异均无统计学意义。结论：脊柱侧凸后对躯干屈曲和后伸运动时椎旁肌的激活产生了不对称影响，但对腹直肌影响较小。侧凸导致躯干核心肌力及肌耐力下降，运动功能表现较健康同龄人差。AIS患者的康复评估应关注患者的躯干双侧椎旁肌的平衡，治疗方案建议融入核心稳定训练。 |
| 英文摘要: |
| Objective: To investigate the effects of low back muscle and motor function in adolescent idiopathic scoliosis (AIS) patients compared with healthy people, and to provide theoretical basis for rehabilitation assessment and intervention treatment of clinical AIS patients. Methods: All 27 cases of S-type AIS patients with lumbar bending and main bending were included as the experimental group. A total of 30 healthy peers were recruited as the healthy group. The activation of the paravertebral and abdominal muscles during trunk flexion and extension was measured using surface electromyography. Core stability was assessed by trunk flexion and extension strength and endurance tests. Functional Movement Screen (FMS) was used to assess motor function and screen for the risk of sports injuries. Results: In trunk flexion and extension tests, there were statistically significant differences in the root mean square (RMS) of paravertebral muscles in the parietal and upper and lower ends of the AIS patients, and that on the convex side was significantly greater than that on the concave side (P<0.05，0.01). There was no significant difference in the RMS value of the rectus abdominalis muscle between the convex and concave side. The RMS ratio of paravertebral muscle in the apical and upper and lower end in the AIS group was greater than 1, and the RMS ratio of bilateral paravertebral muscle in the healthy group was close to 1, and the difference between the two groups was statistically significant (P<0.05，0.01). However, there was no significant difference in the activation of rectus abdominis between the two groups. Compared with healthy people, the trunk flexion and extension muscle strength and muscle endurance of AIS patients were decreased (P<0.05，0.01). In the FMS evaluation, the total score of AIS group was lower than that of healthy group (P<0.05，0.01). In the movement subdivision, except that the score of FMS-1 was lower in the AIS group than that of healthy group (P<0.01), there was no significant difference between the two groups in the other 6 FMS movements. Conclusion: The posterior scoliosis has asymmetrical effects on the activation of the paravertebral muscles during trunk flexion and extension, but has less effect on the rectus abdominis muscles. In AIS patients, there is muscle imbalance in the convex and concave side of the spinal paravertebral muscle, and the activation of the convex side is greater than that of the concave side. The core muscle strength and muscle endurance of the trunk were decreased, and the motor function performance was worse than that of healthy peers. Rehabilitation assessment and therapeutic interventions in AIS patients should focus on the patient’s trunk core function and motor performance. The rehabilitation evaluation of AIS patients should focus on the balance of the paravertebral muscles on both sides of the patient’s trunk, and the treatment regimen should include core stability training. |
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