太极拳搂膝拗步动作的踝关节生物力学分析

本文旨在分析太极拳搂膝拗步中踝关节软骨和主要韧带的生物力学响应。采集1名太极拳练习者搂膝拗步及正常行走时的运动学和动力学数据,作为有限元分析的载荷和边界条件,计算关节接触应力和韧带受力。研究结果表明,搂膝拗步动作时踝关节接触应力普遍小于步行时接触应力。但是,在搂膝拗步动作中距腓前韧带、跟腓韧带和距腓后韧带的最大拉力分别为130、169、89 N,对应在步态中仅分别为57、119、48 N。因此,踝关节炎的患者可以适当练习太极拳,但是踝关节外侧韧带扭伤的练习者在搂膝拗步时应适当减小足踝动作幅度。     

痉挛型脑瘫儿童手术后表面肌电信号和关节角度评估

目的 通过表面肌电（surface electromyography,sEMG）和关节角度评估脑瘫儿童手术后运动功能。方法 采集16名痉挛型脑瘫患儿手术前后直线行走时股直肌、股二头肌、半腱肌、胫骨前肌、腓肠肌内外侧sEMG和髋、膝、踝关节角度,计算各步态时期sEMG均方根、积分肌电值和关节角度均值,进行肌力肌张力评估。结果 手术后,患儿下肢肌肉肌张力均显著降低（P＜0.05）,股直肌和股二头肌在摆动阶段肌力减小。胫骨前肌在摆动中末期肌力增大（P＜0.05）。髋、膝关节屈曲角降低（P＜0.05）。踝关节背屈角增大（P＜0.05）,内翻角减小（P＜0.05）。结论 治疗后患者蹲伏步态和马蹄内翻足均得到改善,运动功能得到提升。sEMG结合关节角度分析可对患者肌肉功能进行定量评估,为临床诊断提供参考。     

老年人搂膝拗步动作的下肢运动协调特征分析

目的 探讨 65 岁以上健康老年人进行太极拳搂膝拗步动作时下肢运动的协调性和稳定性。 方法 30 名太极拳练习者随机完成步行和搂膝拗步动作,采用 Vicon 三维动作捕捉系统收集下肢运动学数据。 结果 搂膝拗步动作时,矢状面关节角度和髋-膝和膝-踝关节相位值变换频繁,髋-膝和膝-踝关节的平均相对相角绝对值以及髋、膝关节平均标准差显著小于步行。 结论 与步行相比,太极拳搂膝拗步动作时髋-膝和膝-踝关节呈现出更协调稳定的关节间运动模式。 太极拳锻炼可能会为老年人提供一种特定的协调训练方式,提高姿势稳定性,预防跌倒发生。     

太极拳转体动作中下肢关节活动顺序性和肌肉力表现及肌肉激活特征

目的 分析太极拳转体与弓步动作中下肢关节活动顺序性、肌肉力表现和肌肉激活程度的差异,揭示太极拳转体动作的特征。 方法 募集 20 名练习时长超过 3 年的健康太极拳练习者,采用三维运动捕捉系统、测力台和表面肌电同步采集转体与弓步两种动作运动学、动力学和肌肉激活信息,并通过 OpenSim 仿真软件获取下肢肌力。结果 与弓步相比,转体动作髋、踝关节外旋幅度显著增大;膝关节外展和外旋力矩显著增大,股二头肌、半腱肌和内外侧腓肠肌峰值肌力显著增强,股二头肌、内外侧腓肠肌峰值肌力时刻显著提前,而股内外侧肌和胫骨前肌峰值肌力显著减小,胫骨前肌肌力最早达到峰值;股二头肌、股内外侧肌和内侧腓肠肌的平均激活水平和激活时间显著增加。 结论 太极拳转体动作由踝、髋关节依次转动组成,肌肉力表现的独特性在于重心两次转移致使支撑腿内外侧肌力曲线呈双峰型,因为全足着地延迟方式引发了腓肠肌与股四头肌激活顺序和肌肉平均激活水平改变。研究结果提示全足着地延迟方式具有调节肌肉激活顺序的作用,合理利用有助于提升临床康复效果。     

太极拳上步弓步动作足前进角对膝关节载荷的影响及肌肉协调收缩策略

目的考察太极拳运动姿势对膝关节载荷的影响及肌肉协调收缩策略。方法募集20名具有3年以上健康太极拳习练者,借助红外高速运动捕捉系统和三维测力台,采集太极拳上步弓步动作支撑腿内收角、胫骨角、关节力、关节力矩等参数,通过仿真方法获取股四头肌和腓肠肌肌肉力。比较惯用步、外展步和内收步肌肉力表现、募集模式和激活方式特征。结果外展步胫骨角和内收力增大,而内收步不变;外展步股内肌、半膜半腱肌及外侧腓肠肌力增大;内收步股外肌和内侧腓肠肌力增强,腓肠肌比股四头肌被优先激活,肌群募集方式发生改变。结论太极拳运动姿势改变肌肉力募集方式,影响膝关节功能,规范动作可作为骨性关节炎运动疗法借鉴,具有临床应用意义。     

基于AnyBody仿真的太极拳不同步型特征

目的 对比太极拳初学者和专业者不同步型的下肢运动学、动力学、肌肉力参数差异,为太极拳科学化及制定运动处方提供依据。方法 以练习时长超过3年的30名太极拳练习者为专业组,30名无太极拳经历初学者作为对照组。用BTS红外捕捉系统、Kistler三维测力台采集太极拳动作数据,以AnyBody 7.0建模仿真系统计算运动学、动力学、肌力参数。结果 专业组独立步膝关节屈伸角度、膝关节X轴受力明显大于对照组（P＜0.01）。弓步、虚步、开立步、马步、仆步、独立步中,专业组下肢肌力均为大于对照组。专业组马步半膜肌、半腱肌、股二头肌肌力大于对照组（P＜0.05）,专业组仆步臀大肌、臀中肌、臀小肌、阔筋膜张肌、股外侧肌、股二头肌肌力大于对照组（P＜0.05）,独立步股外侧肌、股内侧肌、股二头肌、胫骨前肌肌力大于对照组（P＜0.05）。结论 太极拳练习时,膝关节为主要发力关节,专业者下肢用力明显大于初学者。独立步对髋关节影响较大,弓步、仆步对膝关节影响较大。不同水平太极拳练习者对下肢肌肉的激活程度不同,初学者练习时要针对不同动作影响刺激的肌肉,有针对性地区分练习,进而促进下肢肌肉协同用力。     

自然行走对人体足底压力与下肢表面肌电信号影响的研究

目的 探究自然行走对正常人足底压力与下肢肌肉表面肌电信号(sEMG)的影响.方法 分别测量28例健康青年男性受试者在30 min平地自然行走前后足底压力与下肢肌肉的sEMG,得到行走前后峰值压强、冲量等足底压力参数及胫骨前肌、腓肠肌、股直肌与股二头肌的表面肌电时域参数积分肌电(iEMG)和频域参数平均功率频率(MPF),并检验峰值压强与身高、体质量的相关性.结果 平地自然行走开始时和30 min后,其左、右侧的峰值压强、冲量等各特征参数的差异均有统计学意义(均P＜0.05),不同参数的左、右侧差异分别体现在足底不同区域,而在跖骨区M3、M4、M5处各参数均表现出左侧大于右侧;行走前后左侧胫骨前肌、腓肠肌、骨直肌与股二头肌sEMG的iEMG均大于右侧;行走前后左侧胫骨前肌、腓肠肌的MPF大于右侧,其差异具有统计学意义(P＜0.05).30 min行走后右足脚趾区Toe2-5的峰值压强降低,其差异具有统计学意义(P＜0.05);各肌肉表面肌电iEMG无显著性变化,左侧股直肌的表面肌电信号的MPF显著性下降;峰值压强与身高、体质量均呈弱相关.结论 正常人自然行走中,足底压力和下肢表面肌电均具有左右侧的差异;30 min自然行走尚未导致足底压力出现明显疲劳状态的相应结果,因此自然行走30 min可维持步态的稳定性;30 min行走将导致左侧股直肌出现疲劳.     

膝骨关节炎患者膝关节置换后下肢肌的表面肌电图变化

背景：膝骨关节炎患者膝关节置换后下肢肌功能恢复一直存在着争议。 目的：评价膝骨关节炎患者膝关节置换手术后下肢肌肉功能。 方法：应用TELEMYO 2400R G2表面肌电图遥测仪对25例双膝骨关节炎单膝关节置换后患者在平常自然步态下进行双下肢股直肌、胫前肌、股二头肌和腓肠肌内侧的表面肌电信号测试。在肌电图测试前,对患者双膝关节功能进行美国特种外科医院膝关节评分。 结果与结论：患者置换后美国特种外科医院膝关节评置换侧平均分91.44,其优良率达100%;未置换侧平均分54.52。置换侧在疼痛、关节功能方面有明显改善;膝关节置换后置换侧股直肌、胫前肌、股二头肌的肌电振幅、肌电积分、平均频率、中位频率的(平均值、最小值、最大值)与未置换侧相比差异无显著性意义(P > 0.05);置换侧腓肠肌内侧肌电振幅值及肌电积分值显著大于未置换侧(P < 0.05);置换侧腓肠肌内侧平均频率、中位频率与未置换侧相比差异无显著性意义(P > 0.05)。提示膝关节置换后置换侧的下肢肌没有恢复到正常的功能活动水平,因此膝关节置换后康复要特别重视患者的肌肉锻炼。中国组织工程研究杂志出版内容重点：人工关节;骨植入物;脊柱;骨折;内固定;数字化骨科;组织工程全文链接：     

冲击载荷作用下运动员下肢动态响应的逆向动力学仿真

目的分析冲击载荷作用下羽毛球运动员下肢关节肌肉的动态响应变化。方法基于Any Body Modeling System软件建立人体肌骨模型,采用实测表面肌电信号进行验证,以运动捕捉系统和测力台测量数据进行模型驱动,对羽毛球右前场蹬跨步上网过程中下肢肌肉肌力、关节力和关节力矩进行逆向动力学仿真与分析。结果所建人体下肢肌骨模型经肌电信号验证有效。羽毛球蹬跨步上网过程中,髋、踝关节Z方向内力峰值显著高于X和Y方向内力峰值,而膝关节X方向内力峰值显著高于Y和Z方向内力峰值;缓冲期,髋关节X、Y、Z方向依次表现为内收力矩、伸髋力矩和内旋力矩,膝关节X、Y、Z方向依次表现为外展力矩、屈膝力矩、外旋力矩,踝关节X、Y方向依次表现为内翻力矩、跖屈力矩,且髋、膝、踝关节X方向力矩峰值显著高于Y和Z方向;股外侧肌、股二头肌、胫骨前肌、腓肠肌内侧在对抗地面冲击载荷时的肌力发挥较大,股直肌、半膜肌、比目鱼肌发挥的作用相对较小。结论建立的下肢肌骨模型可为冲击载荷作用下运动员下肢生物力学特性分析提供技术平台。为避免运动损伤,类似羽毛球前场蹬跨步上网冲击动作中尤其要重视触地瞬间地面反作用力载荷对髋、膝、踝关节前后及内外侧方向生物力学性质的影响,同时在对羽毛球运动员进行专项训练时切勿忽视对股外侧肌、股二头肌、胫骨前肌的专项力量发展。     

意外滑动过程中人体下肢关节与肌群的自主平衡调节作用研究

针对受扰条件下的步态失稳现象,国内外学者已做了一定的研究工作,但有关失稳过程中自主平衡行为与表面肌电信号及步态参数之间的表征关系却鲜有涉及。本文将步态分析与肌电信号分析相结合,研究在水平步道行走时,足跟着地后发生意外滑动的情况下,人体下肢关节和肌群的自主平衡调节机制。本文募集10位健康受试者,统一着鞋,采集分析了在干燥步道和油面步道两种不同行走条件下的下肢关节力矩、关节角度和主要参与肌群表面肌电信号等参数的变化规律。研究表明:发生意外滑动时人体通过增大踝关节背屈力矩、髋关节和膝关节伸直力矩与膝关节伸直角度,并及时调整相关肌肉激活延迟时间(依次激活胫骨前肌→股直肌→腓肠肌→股二头肌)来调节身体重心位置以维持平衡、避免滑倒。本文的研究结果可为防止滑跌损伤、康复训练以及下肢助行装置的研发等领域开拓新的思路并提供一定参考价值。     

Motor patterns of a fast voluntary postural task in man: trunk extension in standing

The co-ordination between muscles controlling the primary movement and associated postural adjustments during fast trunk extension movements was studied in six male subjects. Myoelectrical activity (EMG) was recorded from antagonistic muscle pairs at the trunk, hip, knee and ankle. Horizontal displacements of the upper trunk, hip and knee were recorded with an opto-electronic system (Selspot). A backward displacement of the trunk was accompanied by a forward displacement of the hip and knee. In general, the trunk started to move 30 ms before the hip and knee. Muscle activity first appeared in the ankle extensors (soleus/gastrocnemius) up to 150 ms prior to onset of prime mover muscles (trunk extensor, erector spinae; and hip extensors/knee flexors, hamstrings). This pre-activation was seldom followed by any detectable ankle joint movement. Prime mover muscles were activated simultaneously followed by the hip extensor gluteus maximus. Time to activation of muscles braking the movement (rectus abdominis, rectus femoris and vastus lateralis) was correlated with the amplitude of the primary movement (r = 0.63 0.75, P less than 0.01). Onset of activity in vastus lateralis was highly correlated with the amplitude of the forward displacement of the knee (r = 0.93, P less than 0.01). An associated postural adjustment appeared as an ankle flexion accompanied by activity in the ankle flexor tibialis anterior, and often also in the ankle extensors. This co-activation of antagonistic ankle muscles can under certain conditions have interesting functional implications for the control of posture.     

穿戴塑料踝足矫形器对下肢肌肉疲劳性的影响

背景：目前尚未见到系统研究踝足矫形器对下肢肌肉影响的文献。 目的：提取正常人穿戴固定踝足矫形器时的下肢肌电信号,分析固定踝足矫形器对下肢肌肉疲劳性的影响。 方法：选择5名健康男性受试者参加试验,每名受试者分别进行3组试验：①第1组,在不穿戴任何矫形器的情况下以自然步态行走。②第2组,受试者穿戴平跟踝足矫形器以自然步态行走(此时矫形器踝部包裹超过踝中心1 cm,记1.0 cm),穿戴同一矫形器但在踝部去掉1.0 cm、踝部塑料边缘刚好通过踝中心时采集(记     0 cm),在踝部再去掉1.0 cm后以自然步态行走(记-1.0 cm)。③第3组,受试者穿戴1.5 cm正常跟高踝足矫形器以自然步态行走,穿戴同一矫形器,但跟高分别改为1.0,2.0 cm后以自然步态行走。行走中采用肌电采集仪检测受试者下肢股二头肌、股直肌、胫骨前肌、腓肠肌的表面肌电信号。 结果与结论：①正常不穿戴任何矫形器时,4块肌肉的肌电信号是最弱的。②对于任何一块肌肉,正常不穿戴矫形器时所对应肌电值比穿戴不同硬度矫形器时所对应的肌电值要小。③对于股二头肌,正常不穿戴矫形器时所对应的积分肌电值与穿戴正常跟高矫形器时所对应的值很接近,同时这两个值要比穿戴不正常跟高矫形器时所对应的积分肌电值小。表明固定塑料踝足矫形器会引起股二头肌、股直肌、胫骨前肌、腓肠肌的疲劳,当固定塑料踝足矫形器的跟高不合适时会进一步增加股二头肌的疲劳程度。中国组织工程研究杂志出版内容重点：生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程全文链接：     

Reliability of leg muscle electromyography in vertical jumping

In this study we aimed to determine the reliability of the surface electromyography (EMG) of leg muscles during vertical jumping between two test sessions, held 2 weeks apart. Fifteen females performed three maximal vertical jumps with countermovement. The displacement of the body centre of mass (BCM), duration of propulsion phase (time), range of motion (ROM) and angular velocity of the knee and surface EMG of four leg muscles (rectus femoris, vastus medialis, biceps femoris and gastrocnemius) were recorded during the jumps. All variables were analysed throughout the propulsion and mid-propulsion phases. Intraclass correlation coefficients (ICC) for the rectus femoris, vastus medialis, biceps femoris and gastrocnemius were calculated to be 0.88, 0.70, 0.24 and 0.01, respectively. BCM, ROM and time values all indicated ICC values greater than 0.90, and the mean knee angular velocity was slightly lower, at 0.75. ICCs between displacement of the BCM and integrated EMG (IEMG) of the muscles studied were less than 0.50. The angular velocity of the knee did not correlate well with muscle activity. Factors that may have affected reliability were variations in the position of electrode replacement, skin resistance, cross-talk between muscles and jump mechanics. The results of this study suggest that while kinematic variables are reproducible over successive vertical jumps, the degree of repeatability of an IEMG signal is dependent upon the muscle studied.     

Reduced plantar cutaneous sensation modifies gait dynamics, lower-limb kinematics and muscle activity during walking

Peripheral neuropathy is the most common long-term complication in diabetes and is involved in changes in diabetic gait and posture. The regression of nerve function leads to various deficits in the sensory and motor systems, impairing afferent and efferent pathways in the lower extremities. This study aimed to examine how reduced plantar-afferent feedback impacts the gait pattern. Cutaneous sensation in the soles of both feet was experimentally reduced by means of intradermal injections of an anaesthetic solution, without affecting foot proprioception or muscles. Ten subjects performed level walking at a controlled velocity before and after plantar anaesthesia. Muscle activity of five leg-muscles, co-contraction ratios for the knee and ankle joint, ground reaction forces (GRF), spatiotemporal characteristics, joint angles and moments of the hip, knee and ankle were analysed. The intervention significantly lowered plantar sensation, reducing it to the level of sensory neuropathy. Spatiotemporal gait characteristics remained unchanged. The ankle joint was more dorsiflexed which coincided with increased tibialis anterior and decreased gastrocnemius medialis muscle activity during foot flat to mid-stance. In addition, the knee joint was more flexed accompanied by increased biceps femoris activity and higher internal knee-extension moment. With regard to gait dynamics, a delay of the first peak of the vertical GRF was observed. Increased soleus and tibialis anterior muscle activity were found during the end of stance. Short-term loss of plantar sensation affects lower-limb kinematics and gait dynamics, particularly during the first half of stance, and contributes to modified muscle-activation patterns during locomotion.     

Synchronization of lower limb motor unit activity during walking in human subjects

Synchronization of motor unit activity was investigated during treadmill walking (speed: 3-4 km/h) in 25 healthy human subjects. Recordings were made by pairs of wire electrodes inserted into the tibialis anterior (TA) muscle and by pairs of surface electrodes placed over this muscle and a number of other lower limb muscles (soleus, gastrocnemius lateralis, gastrocnemius medialis, biceps femoris, vastus lateralis, and vastus medialis). Short-lasting synchronization (average duration: 9.6 +/- 1.1 ms) was observed between spike trains generated from multiunit electromyographic (EMG) signals recorded by the wire electrodes in TA in eight of nine subjects. Synchronization with a slightly longer duration (12.8 +/- 1.2 ms) was also found in 13 of 14 subjects for paired TA surface EMG recordings. The duration and size of this synchronization was within the same range as that observed during tonic dorsiflexion in sitting subjects. There was no relationship between the amount of synchronization and the speed of walking. Synchronization was also observed for pairs of surface EMG recordings from different ankle plantarflexors (soleus, medial gastrocnemius, and lateral gastrocnemius) and knee extensors (vastus lateralis and medialis of quadriceps), but not or rarely for paired recordings from ankle and knee muscles. The data demonstrate that human motor units within a muscle as well as synergistic muscles acting on the same joint receive a common synaptic drive during human gait. It is speculated that the common drive responsible for the motor unit synchronization during gait may be similar to that responsible for short-term synchronization during tonic voluntary contraction.     

Fast voluntary trunk flexion movements in standing: motor patterns

The electromyographical (EMG) activity was studied during voluntary flexion movements of the trunk in erect standing man. The movements were performed at maximal velocity with successively increasing amplitude to cover the whole range of motion. The EMG activity was recorded from agonist-antagonist pairs of muscles at the ankle, knee, hip and trunk. The angular displacements at the corresponding joints were recorded using a Selspot optoelectronic system. The duration of initiating activity in prime movers (rectus abdominis and rectus femoris) as well as time to onset of activity in muscles braking the primary movement (erector spinae, gluteus maximus and hamstrings) were highly correlated with amplitude, duration, peak velocity and time to peak velocity of the movement (r = 0.59-0.91). The corresponding correlations for peak acceleration and deceleration of the movement were low (r = 0.03-0.38), indicating that acceleration and deceleration of a movement was not coded in the temporal aspects of the EMG. Onset of activity in rectus abdominis and rectus femoris as well as an early appearing burst of activity in vastus lateralis were invariant in relation to start of movement over the whole movement range. In the initial phase of a fast trunk flexion, activity in tibialis anterior appeared successively earlier with increasing movement amplitude. This resulted in a changed order of activation for the muscles from proximal to distal (rectus abdominis first) to distal to proximal (tibialis anterior first). Two different forms of associated postural adjustments are present during a fast trunk flexion, one early fast knee flexion and a later slower angle extension. Prior to knee flexion, no activity was recorded from muscles flexing at the knee implying that some other force must create a flexing torque around the knee. It is suggested that activity in rectus abdominis initiating the primary movement also initiates knee flexion through the upward pulling of pelvis. This would be possible since rectus femoris stabilizes the pelvis in relation to the leg, allowing the force in rectus abdominis to be transmitted below the hip joint and act extending around the ankle joint. However, when tibialis anterior is activated it stabilizes the shank which in turn will cause a knee flexion controlled by a lengthening contraction in vastus lateralis. During the subsequent ankle extension activity appears in lateral gastrocnemius and soleus causing the associated postural adjustment at the ankle. It can be concluded that activation of postural muscles prior to prime mover muscles is not always necessary.(ABSTRACT TRUNCATED AT 400 WORDS)