肌电生物反馈联合康复训练对脊髓损伤患者运动功能及功能独立性的影响

目的:观察肌电生物反馈疗法联合康复训练对脊髓损伤(SCI)患者运动功能障碍的康复疗效。方法:60例胸腰段不完全性脊髓损伤患者随机分为观察组和对照组,每组30例。2组均进行常规康复治疗,观察组加用双下肢肌电生物反馈治疗。治疗前及治疗后8周、12周进行下肢肌肉最大收缩时表面肌电(sEMG)信号采集、运动功能评定及功能独立性(FIM)评定,比较临床疗效。结果:治疗8周后,2组患者股四头肌、胫前肌最大收缩时的sEMG信号均较治疗前明显提高(P0.05),治疗后12周继续提高(P0.01);观察组sEMG信号增幅高于对照组(P0.05)。治疗8周后,2组患者ASIA运动功能评分及FIM评分亦较治疗前提高(P0.05),组间比较差异无统计学意义;治疗12周后,2组ASIA运动功能及FIM评分较治疗8周后提高更明显(P0.01),观察组更高于对照组(P0.05)。结论:肌电生物反馈疗法联合康复训练对胸腰段不完全性脊髓损伤患者运动功能有促进作用,能明显提高患者的股四头肌、胫前肌表面肌电信号及肌力,并能提高功能独立水平,减少并发症。     

The role of the prefrontal cortex in the development of muscle fatigue in Charcot–Marie–Tooth 1A patients

This study aimed at comparing both peripheral and central mechanisms of muscle fatigue between Charcot–Marie–Tooth 1A patients and healthy individuals during a fatiguing voluntary task by simultaneous electromyographic and electroencephalographic recordings. Six Charcot–Marie–Tooth 1A patients (3 females, 40 ± 11 years) and 6-matched healthy individuals performed four blocks of sub-maximal isometric knee extensions. At the beginning of the session and after each block, electrically-evoked maximal single-twitch, maximal voluntary contraction and surface-electromyography of the vastus lateralis muscle were measured. The movement-related-cortical potentials were averaged in early (block 1–2) and late (block 3–4) stages of fatigue. The effect of fatigue was demonstrated at peripheral level by the decline of maximal voluntary contraction, maximal twitch and surface electromyography amplitude and at central level by the larger amplitude of movement-related-cortical-potentials during late than early stage of fatiguing sub-maximal contractions. Charcot–Marie–Tooth 1A patients showed lower motor cortex activity during motor planning, with earlier onset and larger prefrontal cortex activity during the late stage of the fatiguing task than healthy controls. These data demonstrate the key role of the prefrontal cortex in the development of fatigue in Charcot–Marie–Tooth 1A patients, which may be activated as a compensatory mechanism for the low motor cortex activation, thus reflecting high awareness of movement complexity.     

便携式实时肌疲劳分析系统研制

目的针对运动科学领域的需求,开发一套便携式肌疲劳实时分析系统。方法系统由信号采集端、FPGA信号处理端和结果显示存储端组成。信号采集端由六通道肌电传感器通过Ag-Ag Cl电极采集人体表面肌电信号,经过1 K采样率ADC转化,由C8051F410控制蓝牙2.0模块发送信号到FPGA信号处理端。FPGA信号处理端接收s EMG信号、解析数据、提取活动段、并计算与肌疲劳分析相关的时频域参数。结果显示存储端通过S3C6410控制LCD显示以及SD卡存储。结果系统实现了六通道s EMG的实时采集以及肌疲劳参数的实时计算、显示和存储。对16位受试者的踢腿运动肌疲劳分析验证了系统的有效性。结论研制的肌疲劳实时分析系统具有强大的实时肌疲劳分析功能,同时具有便于携带、使用方便、可扩展等特点,适用于日常运动疲劳监测。     

Functional Benefits of Dysphagia Therapy Using Adjunctive sEMG Biofeedback

This article describes a retrospective analysis of functional outcome, time in therapy, and cost per unit of functional change in patients who received therapy for pharyngeal dysphagia. Twenty-five patients presenting dysphagia following stroke and 20 patients with dysphagia following treatment for head/neck cancer completed a systematic therapy program supplemented with surface electromyographic (sEMG) biofeedback. Eighty-seven percent (39/45) of all patients increased their functional oral intake of food/liquid including 92% of stroke patients and 80% of head/neck cancer patients. Patients with dysphagia following stroke demonstrated greater improvement than those in the head/neck cancer group. Patients in the stroke group completed more therapy sessions thus increasing the total cost of therapy, but they made more functional progress resulting in lower costs per unit of functional change than patients in the head/neck cancer group. Limitations of this study are described in reference to implications for future clinical research on the efficacy of this therapy approach.     

电极放置位置对表面肌电信号特征的影响

目的:探讨不同电极放置位置对表面肌电(sEMG)信号特征的影响。方法:健康男性大学生14名,分别采用50%、70%和90%最大随意收缩力量(MVC)强度静态屈肘运动诱发肱二头肌疲劳,同步采集肱二头肌上三个不同电极位置上的sEMG信号,采用线性和非线性信号分析方法,计算线性指标平均肌电值(AEMG)和平均功率频率(MPF)以及非线性指标C(n)和DET%。结果:电极位置只对sEMG的四个测试指标的均值产生影响,对其变化斜率无明显影响,而四个指标的变化斜率中,除AEMG变化斜率对负荷强度无明显区分度外,其余三个指标对负荷强度均有良好区分度。结论:采用MPF、C(n)和DET%变化斜率作为评价局部肌肉疲劳的客观指标,既可以忽略电极放置位置对sEMG的影响,又对不同负荷强度有良好区分度。     

一种基于表面肌电信号映射人体下肢运动意图的方法

智能膝关节假肢是截肢患者恢复日常运动的重要辅具。对人体下肢运动意图的识别是实现下肢假肢控制的关键。该文针对此问题,提出了一种通过表面肌电信号预测膝关节角度的方法。对表面肌电提取时域特征,通过 BP 神经网络模型建立平地行走过程中表面肌电信号和膝关节角度的映射关系,预测膝关节角度。     

咬合支持丧失患者修复前后咀嚼肌表面肌电分析

目的：探讨咬合支持丧失患者修复前后咀嚼肌肌电的变化。方法：对24例咬合支持丧失患者进行常规修复,记录不同时期双侧咬肌和颞肌前束在下颌姿势位及牙尖交错紧咬位时的肌电活动,分析肌电幅值、不对称指数及咬肌/颞肌活动指数的变化。结果：（1）修复前后下颌姿势位肌电变化,咬肌肌电幅值和不对称指数在不同时期无明显变化（P〉0.05）;颞肌肌电幅值和不对称指数在义齿戴用3个月以上后显著小于义齿早期（P〈0.05）;咬肌/颞肌前束活动指数在各时期均小于0。（2）修复后牙尖交错位紧咬时肌电变化,咬肌及颞肌前束肌电幅值在戴牙3个月后显著高于戴牙早期（P〈0.05）;不对称指数与初戴牙时接近（P〉0.05）,较戴牙1周及1个月显著减小（P〈0.05）。咬肌/颞肌前束活动指数值在各时期均接近0。结论：咬合支持丧失患者进行咬合重建过程中,咀嚼肌肌电活动在不同时期有所变化。肌电测量可为咬合重建效果的评价提供参考。     

一种基手SEMG评估上肢康复机器人有效性的秀法

将表面肌电信号（sEMG）运用到上肢康复机器人的有效性评估方面,提供一种方便有效的针对外骨骼康复机器人的训练效果评估方法,有利于针对不同机械结构的外骨骼机器人采用小同的康复医疗方案。利用肌电信号时域分析的积分机电值iEMG和均方根值RMS等肌电信号特征,并结合对肌电图的分析设计出针对六自由度上肢外骨骼机器人的对心训练方案,并对该套机器人系统进行科学的有效性评估。