膝关节骨关节炎患者膝屈伸肌的表面肌电信号研究

目的 评价单侧膝关节骨关节炎（OA）患者在不同运动状态下的健、患侧膝屈伸肌的肌肉功能和协调活动差异，为临床制定康复方案提供依据。方法 用Noraxon Myosystem1200型表面肌电图仪对26例单侧膝关节骨关节炎患者的等长肌肉收缩功能和下蹲运动进行表面肌电信号的测试。结果 患侧股外侧肌和股二头肌在最大等长收缩和下蹲运动时的肌电振幅均值小于健侧（P〈0．05）。在最大等长收缩过程中，患侧的拮抗肌协同收缩率较健侧增高（P〈0．05）；在下蹲运动过程中，患侧的胭绳肌共同活动比率高于检测（P〈0．05）。结论 表面肌电图测试可用于量化评价膝OA患者在不同运动过程中肌肉功能。膝OA患肢在不同运动状态下均可能存在肌肉功能降低和肌力平衡异常。康复治疗不仅应重视股四头肌肌力增强而且应重视改善膝关节的肌力平衡。

Surface electromyography of patients with knee osteoarthritis

Objective To evaluate muscular function and the coactivity of the knee flexors and extensors in patients with unilateral osteoarthritie knees.Methods Muscle function and coactivity were tested in 26 patients with unilateral osteoarthritic knees during maximal voluntary contraction and during squats,using a Noraxon Myosys- tern 12000 surface electromyography (sEMG) system.Results The mean amplitude of the electromyograms of the vastus lateralis and biceps femoris in diseased knees were significantly lower during maximal voluntary contraction and squat than those of the non-diseased knees.The antagonistic coactivity ratios in diseased knees were higher than in the non-diseased during isometric contraction,and hamstring coactivity ratios were also higher.Patients with knee os- teoarthritis demonstrated impaired muscular function and altered muscle balance.Conclusions SEMG can be used to quantitatively evaluate muscle function in patients with osteoarthritic knees.Therapeutic interventions should focus not only on quadrieeps strengthening,but also on improving muscle balance at the knee.