正常者下颌运动的肌电活动研究

目的研究正常者在姿势位及下颌不同运动中,双侧颞肌前束(TA),后束(TP),嚼肌(MM),二腹肌前腹(DA)的肌电活动情况。方法采用美国BioEMGⅡ八道表面肌电仪和瑞士Kistler双极表面电极,同步记录30例正常者上述诸肌的肌电变化。结果①姿势位:TA,TP,MM,DA均有轻微的肌电活动,其中TP的活动比较明显,起主要作用;②正中位最大紧咬:TA,TP,MM均有强烈的肌电活动,其肌电压值达到最高峰,TA肌电活动最大,其次为MM,再次为TP;③前伸运动:MM,DA的肌电活动大于TA,TP;④后退运动:DA肌电活动最明显,其次为TP;⑤左右侧方运动:肌电活动主要表现在同侧TA和TP,对侧MM和左右侧DA。结论TA是重要的升颌肌;TP是维持姿势位、下颌后退和侧方运动的主要肌肉;MM为下颌紧咬产生咬力,以及下颌前伸的主要肌肉;DA参加下颌的各种运动,起调节作用。     

改良固定反式TBA联合前牵矫治AngleⅢ类前牙反(牙合)的肌电研究

目的：应用改良固定反式双阻板矫治器（Twin-block appliance，TBA）联合前牵治疗AngleⅢ类轻．中度骨性前牙反[牙合]，进行肌电研究，探讨在矫治过程中咀嚼肌功能活动的变化规律，以期从咀嚼肌适应性改建来探讨其作用机制。方法：调查颞肌前束（TA）、咬肌（MM）、二腹肌前腹（DA）治疗前、中、后肌电活动变化情况。结果：矫治后姿势位TA．DA、MM肌电值（MCV）明显下降；反[牙合]时下颌前伸位TA及DA存在异常的肌电活动，在治疗后均明显降低；治疗前后退位MM、TA及DA肌电活动与对照组相比均较大，具有显著性差异，治疗结束后明显下降；反[牙合]解除后紧咬及双侧咀嚼运动MM、TA及DA肌电水平明显增加。结论：反式TBA联合前牵全天作用可引起神经肌肉的适应性改建。     

正常[牙合]者下颌运动的肌电活动研究

目的 研究正常[牙合]者在姿势位及下颌不同运动中，双侧颞肌前束（TA），后束（TP），嚼肌（MM），二腹肌前腹（DA）的肌电活动情况。方法 采用美国BioEMGⅡ八道表面肌电仪和瑞士Kistler双极表面电极，同步记录30例正常[牙合]者上述诸肌的肌电变化。结果 ①姿势位：TA，TP，MM，DA均有轻微的肌电活动，其中TP的活动比较明显，起主要作用；②正中[牙合]位最大紧咬：TA，TP，MM均有强烈的肌电活动，其肌电压值达到最高峰，TA肌电活动最大，其次为MM，再次为TP；③前伸运动：MM，DA的肌电活动大于TA，TP；④后退运动：DA肌电活动最明显，其次为TP；⑤左右侧方运动：肌电活动主要表现在同侧TA和TP，对侧MM和左右侧DA。结论 TA是重要的升颌肌；TP是维持姿势位、下颌后退和侧方运动的主要肌肉；MM为下颌紧咬产生咬胎力，以及下颌前伸的主要肌肉；DA参加下颌的各种运动，起调节作用。     

改良固定反式TBA联合前牵矫治AngleIII类前牙反的肌电研究

目的:应用改良固定反式双阻板矫治器(Twin-blockappliance,TBA)联合前牵治疗AngleIII类轻、中度骨性前牙反牙合,进行肌电研究,探讨在矫治过程中咀嚼肌功能活动的变化规律,以期从咀嚼肌适应性改建来探讨其作用机制。方法:调查颞肌前束(TA)、咬肌(MM)、二腹肌前腹(DA)治疗前、中、后肌电活动变化情况。结果:矫治后姿势位TA、DA、MM肌电值(MCV)明显下降;反牙合时下颌前伸位TA及DA存在异常的肌电活动,在治疗后均明显降低;治疗前后退位MM、TA及DA肌电活动与对照组相比均较大,具有显著性差异,治疗结束后明显下降;反牙合解除后紧咬及双侧咀嚼运动MM、TA及DA肌电水平明显增加。结论:反式TBA联合前牵全天作用可引起神经肌肉的适应性改建。     

Ⅲ类错患者的咬合与肌电研究

目的:探讨Ⅲ类错畸形对咬合与肌电的影响。方法:使用T-SCANⅢ与肌电仪对16名Ⅲ类错畸形患者进行检测,其中男7例,女9例,平均年龄(15.59±2.51)岁,采集患者在姿势位、牙尖交错位(ICP)最大紧咬、前伸切对切最大紧咬时的咬合与肌电情况。结果:Ⅲ类患者在姿势位时的颞肌、咬肌肌电高于对照组(P0.05),切对切最大紧咬时低于对照组(P0.05),ICP最大紧咬时与对照组无统计学差异(P0.05)。结论:Ⅲ类错畸形会导致患者咀嚼肌肌电发生异常。     

正常(牙合)者下颌运动的肌电活动研究

目的研究正常(牙合)者在姿势位及下颌不同运动中,双侧颞肌前束(TA),后束(TP),嚼肌(MM),二腹肌前腹(DA)的肌电活动情况.方法采用美国BioEMG Ⅱ八道表面肌电仪和瑞士Kistler双极表面电极,同步记录30例正常牙合者上述诸肌的肌电变化.结果①姿势位:TA,TP,MM,DA均有轻微的肌电活动,其中TP的活动比较明显,起主要作用;②正中牙合位最大紧咬:TA,TP,MM均有强烈的肌电活动,其肌电压值达到最高峰,TA肌电活动最大,其次为MM,再次为TP;③前伸运动:MM,DA的肌电活动大于TA,TP;④后退运动:DA肌电活动最明显,其次为TP; ⑤左右侧方运动:肌电活动主要表现在同侧TA和TP,对侧MM和左右侧DA.结论 TA是重要的升颌肌;TP是维持姿势位、下颌后退和侧方运动的主要肌肉;MM为下颌紧咬产生咬(牙合)力,以及下颌前伸的主要肌肉;DA参加下颌的各种运动,起调节作用.     

成人骨性反(牙合)的咀嚼肌肌电特征

目的:本研究通过对成人骨性反牙合患者主要咀嚼肌肌电检查分析,揭示成人骨性反牙合畸形对咀嚼肌功能的影响。方法:20名患者均为需正畸与正颌手术联合治疗的成人骨性反牙合患者。利用肌电图仪测试咬肌、颞肌前束、二腹肌前腹在功能活动中肌电变化。结果:与对照组相比,咬肌、颞肌前束和二腹肌前腹的肌电,除个别功能位外,与对照组均有显著不同,其中咬肌的肌电变化最明显。咀嚼肌在姿势位、前伸位、后退位、张口位、闭口位的肌电值增大;双侧咀嚼时,咀嚼肌的肌电是下降的。结论:骨性反牙合患者的咀嚼肌肌肉长期处于紧张状态,咀嚼肌肌电异常,患者咀嚼功能低下。     

下颌偏突颌畸形患者双侧下颌骨升支矢状劈开术前后咀嚼肌功能变化探究

目的:探究下颌偏突颌畸形患者双侧下颌骨升支矢状劈开术(BSSRO)前后咀嚼肌功能变化。方法:选取2016年6月-2018年6月笔者医院收治的31例下颌偏突颌畸形患者为观察组,另选取30例年龄相仿的正常志愿者为对照组。测定两组自由咀嚼状态下的半分钟咀嚼效能、吞咽反射前咀嚼效能。采用OXFORD双通道肌电诱发仪采集两组紧咬位、大张口运动的MML、MMR、TAL、TAR肌电值;计算相应部位的咀嚼肌活动量指数(AcI)。结果:术前,观察组患者的半分钟及吞咽反射前咀嚼效能,紧咬位、大张口运动时的MML、MMR、TAL、TAR及AcI指标均低于对照组,差异有统计学意义(P<0.05);术后3个月,观察组患者的咀嚼效能指标及各功能运动中的MML、MMR、TAL、TAR肌电值均明显小于对照组及术前(P<0.05),各功能运动中AcI指标明显大于术前(P<0.05);术后1年,观察组患者的咀嚼效能指标及各功能运动中的MML、MMR、TAL、TAR肌电值均明显高于术后3个月(P<0.05),但部分指标仍与对照组无差异(P>0.05)。结论:下颌偏突颌畸形患者术前的咀嚼肌功能弱于健康人群,行BSSRO后咀嚼肌功能得到了一定程度的改善。     

正畸全冠修复在前牙冠根折患者中的应用效果

目的 探究对前牙冠根折患者采用正畸全冠修复治疗的临床效果。方法 选取2019年1月-2021年 12月张家口市口腔医院收治的80例前牙冠根折患者为研究对象,按照随机数字表法分为对照组和观察组, 每组40例。对照组予以烤瓷全冠修复,观察组予以正畸牵引后烤瓷全冠修复,比较两组临床疗效、前牙 咬合功能[牙尖交错位习惯咬合状态（ICP-HB）肌电值、最大力紧咬合状态（ICP-MC）肌电值]及美学 效果[红色美学指数（PES）]。结果 观察组治疗优良率为95.00%,高于对照组的77.50%,差异有统计学 意义（P＜0.05）;两组修复后ICP-HB肌电值、ICP-MC肌电值均高于修复前,且观察组高于对照组, 差异有统计学意义（P＜0.05）;两组修复后PES评分均高于修复前,且观察组高于对照组,差异有统计 学意义（P＜0.05）。结论 正畸全冠修复在前牙冠根折患者中的应用效果确切,可有效改善患者的前牙 咬合功能及牙周、牙龈状况,修复后美学效果较好,值得临床应用。     

正常青年男性嚼肌、颞肌超声形态与软组织面型关系的研究

目的：超声测量正常青年男性浅层嚼肌、颞肌形态指标,了解咀嚼肌形态功能与软组织面型的关系。方法：应用超声成像技术测量69位正常青年男性下颌处于姿势位时浅层嚼肌横截面周长、面积、宽度、最大厚度、平均厚度、纵截面长度及颞肌最大厚度、平均厚度,并与颅面软组织形态指标测量结果及面型比例进行统计学相关分析。结果：下颌处于姿势位时浅层嚼肌的周长、横截面积、最大厚度及平均厚度与颧弓间宽度（bizygomatic facial width,BFW）及下颌角间宽度（intergonial width,IGW）呈正相关（P〈0.05）;颞肌最大厚度、平均厚度与IGW呈正相关关系（P〈0.05）;浅层嚼肌周长、最大厚度、平均厚度与前面高与颧弓间宽度之比（the ratio of the anterior facial height to the bizygomatic facial width,AFH/BFW）及前面高与下颌角间宽度之比（the ratio of the anterior facial height to the intergonial width,AFH/IGW）负相关（P〈0.05）。结论：浅层嚼肌、颞肌形态对软组织面型有显著影响,浅层嚼肌周长、横截面积、厚度及颞肌厚度影响颅面宽度及面高与面宽的比例,可能与方面型有关。     

发育性偏颌畸形患者颈椎姿势特征的研究

目的：探讨发育性下颌偏颌患者的颈椎姿势特征，为改善患者体态提供新的思路。方法：对20例恒牙列下颌偏颌患者及39例正常咬合者拍摄头颅定位后前位、侧位、颈椎标准正、侧位X线片及直立时的面颈和全身照片。结果：偏颌畸形患者颜面明显不对称，直立时一侧胸锁乳突肌肌张力较对侧强、头向一侧偏斜、双肩不等高。矢状面内头颈呈前倾、前伸痊。颈椎正位X片显示颏部及第4、5、6颈椎棘突偏离中线程度大于对照组；颈椎侧位X线显示颈椎曲度小于对照组。结论：偏颌畸形影响颈椎姿势，矫治颌面畸形的同时应注意对异常颈椎姿势的矫治。     

Primär neurogene und myogene Störungen der Körperhaltung

Disturbance of posture may occur in a variety of neurological disorders and occasionally is the presenting or even the only sign. In the majority of cases, the head or the trunk or both are bent forward (bent spine syndrome, dropped head syndrome). A feature of these primary neurogenic or myogenic postural disturbances that is in contrast to antalgic contraction or ankylosis is that they are not fixed, but the trunk or head are easily erected by the examiner and show a characteristic sagging. Neuromuscular disorders are a frequent cause. They may be confined to the paraspinal muscles. Axial computed tomography of the spine, electromyography of the involved muscles, and muscle biopsy help to make the diagnosis. However, also central movement disorders may lead to a sagging of the head or trunk or of both due to a lessened tone of the head and trunk extensors. This is frequently seen in the various parkinsonian syndromes which may, however, occur in association with a focal myopathy of the paraspinal muscles. Occasionally, sagging of the trunk is seen as a side effect of neuropharmacologic medication. Sagging of the trunk or head should be differentiated from a pathologically increased innervation of the ventral muscles in dystonic movement disorders such as antecollis or camptocormia.Pathologic reclination of the head or trunk or both is a rare disturbance of posture. It may occur in dystonia (retrocollis) or, occasionally, as a consequence of musculotendinous contractures secondary to certain neuromuscular disorders such as the rigid spine syndrome.     

喙肩韧带切除后肱骨头移位生物力学初步研究

目的通过对成人尸体肩关节的生物力学研究,建立数个基本的肩关节模型,比较喙肩韧带切除前后肱骨头移位情况,以设计验证改良肩峰成形术控制肱骨头移位的方法。方法取新鲜尸体肩关节6例,其中模拟组1例,实验组5例。通过对模拟组建模并操作后,对实验组5例建立相同模型,以未手术、喙肩韧带切除术进行组内及组间比较,并完成统计分析。结果喙肩韧带切除术后肱骨头前上移位显著增大;对冈上肌、冈下肌及肩胛下肌肌力加强后,所有模型肱骨头移位相对减小,其中加强了冈上肌、肩胛下肌肌力的模型肱骨头移位相对最小。结论通过模拟建立的改良肩峰成形术有利于控制喙肩韧带切除后肱骨头移位。     

Head posture: a case study of the effects on the rest position of the mandible*

Previous research has shown a relationship between head posture and the rest position of the mandible. The purpose in this study was to investigate the changes in the resting vertical dimension of the mandible with correction of a forward head posture in an edentulous patient. Ten treatments of manual physical therapy techniques, such as joint mobilization and muscle stretching to correct the forward head posture, were administered. A plumb line test showed an improvement of the forward head posture. In addition, the resting vertical dimension of the mandible increased an average of 8 millimeters. This result suggests that correct head posture may be necessary to precisely calculate the resting vertical dimension of the mandible.J Orthop Sports Phys Ther 1985;5(4):179-183.     

Initiatory biomechanical study on humeral head migration after coracoacromial ligament cut

Object  To design and evaluate the strength of muscles in preventing humeral head migration after acromioplasty by biomechanical research on cadaver models. Methods  Six fresh shoulder cadavers were studied. The coracoacromial ligament cut model was prepared in five shoulders for the study. Different forces were applied to the head of humerus with designed strengthened force on rotator cuff muscles. The results were calculated with SPSS software. Results  The anterior and superior pulling force caused obvious migration of humeral head in coracoacromial ligament cut model; after strengthening the rotator cuff muscles, especially the supraspinatus and subscapular muscle, the humeral head migration was reduced. Conclusion  Modified acromioplasty with supraspinatus and subscapular muscle, strengthened in our experiment, helped to control the migration of humeral head. An erratum to this article can be found at     

正常人T4~T12肋骨头与相应椎体椎管解剖学及影像学研究

目的:观察正常人肋骨头和相应椎体及椎管的解剖学及影像学关系。方法:解剖测量组(A组),解剖10具正常成人尸体脊柱标本,测量各节段肋骨头对椎体遮挡率(即双侧肋骨头前缘连线到椎管前壁距离与椎体前缘到椎管前缘距离百分比),以及胸椎前路置钉时最大前方安全角度以及最大后方安全角度(最大前方安全角度即以肋骨头为参照物前路牢固置入螺钉时可向椎体前方形成的最大夹角;最大后方安全角度即以肋骨头为参照物置入螺钉时螺钉不进入椎管可向椎体后方形成的最大夹角);影像测量组(B组),测量30例健康成人胸椎CT平扫片,测量CT照片上各节段肋骨头对相应椎体遮挡率、胸椎前路置钉时最大前方安全角度以及最大后方安全角度。结果:两组肋骨头对相应椎体遮挡率自上而下逐渐减小(从T4约30%到T12约-0.4%),越往头侧肋骨头相对于椎体越靠前,越往下胸椎肋骨头定位相对靠后;前方最大安全角度渐增加(T4约27°到T12约38.3°,P<0.05),后方安全角度逐渐减小(T4约23°到T12约-9°,P<0.05),A、B组间比较统计学差异无显著性(P>0.05)。结论:术前CT片的测量肋骨头和相应椎体椎管的关系可指导胸腔镜辅助下胸椎前路手术置钉,在上段胸椎椎体前路置入螺钉时可考虑部分去除肋骨头,在下段胸椎前路置入螺钉时在肋骨头前缘可安全置入螺钉。     

肱三头肌长头重建肩外展的解剖与临床应用

目的对肱三头肌长头进行解剖。描述重建肩外展功能的手术方法，并进行临床随访，明确手术的效果。方法对44侧成人上肢标本解剖观察肱三头肌长头起点的性质、血管神经蒂形态、最大游离范围及入肌点部位。对6例臂丛神经损伤患者行肱三头肌长头起点移位重建肩外展功能，术后随访3～11个月，观察临床应用效果。结果肱三头肌长头起点的背侧为肌性，腹侧为腱性，腱性长度为7.6～13.3cm，宽度为1.6～3.4cm。肱三头肌长头血管神经蒂距肌肉起点的距离5.7～11.4cm。神经支配来自桡神经，可分离长度2.9～11.8cm。血供来自肱动脉的19侧，来自肱深动脉的20侧，其它来源5侧。肱动脉来源的血管蒂长1.0～6.0cm，直径为1.6～2.4mm。肱深动脉的血管蒂可分离长度1.5～4.4cm，直径为0.9～2.4mm，分离至肱动脉长度为1.5～6.3cm。神经血管蒂呈多级分支。6例行肱三头肌长头重建肩外展，术后平均随访6.8个月，术前肩外展5°（0°～10°），术后肩外展77.3°（50°～90°）。结论肱三头肌长头可适用于肩外展功能重建的手术，经术后随访，效果良好。     

Shoulder reaction time and muscle-firing patterns in response to an anterior translation force

The primary restraint preventing humeral head translation is the capsuloligamentous system. Muscle forces can also decrease translation; however, the timing and magnitude of muscle response has not been previously reported. Fine wire electromyographic analysis of the biceps long head, anterior deltoid, pectoralis major, latissimus dorsi, and rotator cuff muscles was performed after an anterior translation force was applied to 15 normal shoulders. The reflex response time (time to 5% maximal muscle test), the protection response time (time to 20% maximal muscle test), the duration of the protection response, and the magnitude of the protection response were calculated. The shoulder reaction data showed 2 consistent patterns. Activation of the anteriorly located muscles preceded the posteriorly located muscles, and the rotator cuff muscles fired with greater magnitude than the more peripherally located muscles.     

Prediction of walking possibility in crawling children in poliomyelitis

Crawling is one of the most common modes of ambulating in children with severe paralysis and deformities in poliomyelitis. Restoring upright posture and bipedal gait, although desirable, has its own limitations due to various factors. Fifty-three children below the age of 12 years (29 boys and 24 girls) crawling due to post-poliomyelitis residual paralysis were assessed for the genesis of crawling as a mode of ambulating. The patterns of crawling were classified according to Cross's classification. Paralyzed muscles and deformities in definite combinations were found responsible for each type of crawling. Trunk muscles, gluteus maximus, quadriceps, hamstrings, tibialis anterior, and triceps surae were identified as muscles crucial for walking in order of priority. At least antigravity power in these muscles was necessary for an upright posture and walking with support. Various combinations of treatment modalities were used to correct the deformities before fitting an orthosis and instituting gait training. Thirty-four children became outdoor walkers, 14 indoor walkers, and five remained nonwalkers. The most favorable patterns of crawling for restoration of upright posture were true quadruped progression (30 cases) and infant-like crawl (14 cases). Average follow-up was 17 months (range, 6 months to 5 years).     

A comparison of surgeons' posture during laparoscopic and open surgical procedures

Background: There is increasing recognition of surgeons' physical fatigue in the new ergonomic environment of laparoscopic surgery. The purpose of this study was to determine what the differences are in the movement of the surgeon's axial skeleton between laparoscopic and open operations. Methods: Surgeons' body positions were recorded on videotape during four laparoscopic (LAP) and six open (OP) operations. The percent of time the head and back were in a normal, bent, or twisted position as well as the number of changes in head and back position were tabulated using a computer program. A separate laboratory study was performed on four surgeons ``walking' a 0.5-inch polyethylene tubing forward and backward using laparoscopic and open techniques. The movements of the surgeons' head, trunk, and pelvis were measured using a three-camera kinematic system (Kin). The center of pressure was recorded using a floor-mounted forceplate (Fp). Results: In the operating room surgeons' head and back positions were more often straight in laparoscopic procedures and more often bent in open operations. The number of changes in back position per minute were significantly decreased when the laparoscopic-only part of surgery was analyzed. In the laboratory the subjects' head position was significantly (p= 0.02) more upright and the anteroposterior (AP) and rotational range of motion of the head was significantly reduced during laparoscopy. Subjects' CP was more anterior and there was a significant reduction in the AP range of motion of the CP during laparoscopy. Conclusions: Our study suggests that surgeons exhibit decreased mobility of the head and back and less anteroposterior weight shifting during laparoscopic manipulations despite a more upright posture. This more restricted posture during laparoscopic surgery may induce fatigue by limiting the natural changes in body posture that occur during open surgery. Received: 3 March 1996/Accepted: 2 July 1996