膝骨关节炎患者股内侧肌、股直肌和股外侧肌间的协调性

目的应用表面肌电图和等速肌力测定方法比较膝骨关节炎患者与正常人股内侧肌、股直肌和股外侧肌间的协调性改变。方法34例膝骨关节炎患者和34名膝关节健康者在膝关节屈曲10°、60°、100°等长伸膝和等速60°/s、180°/s伸膝运动测试模式下,进行股内侧肌(VM)、股直肌(RF)和股外侧肌(VL)的表面肌电图和股四头肌肌力的评测,包括肌肉激活启动顺序和VM/VL神经肌电比值。结果与正常人对比,膝骨关节炎患者在等速180°/s伸膝运动时VM相对于VL启动延迟（P＜0.05）;在膝屈10°等长伸膝运动时,VM/VL神经肌电比值降低（P＜0.05）。结论膝骨关节炎患者患侧股四头肌的协调性减退。     

基于多通道表面肌电探讨不同角速度下膝骨关节炎患者生物力学基础的研究

目的：应用表面肌电图观察和分析膝骨关节炎（knee osteoarthritis,KOA）患者股四头肌表面肌电活动。方法：采用全无线肌电测试系统评测30例KOA患者（KOA组）和30例健康受试者（CON组）在不同角速度（60°/s、90°/s、180°/s）膝关节屈伸运动等速肌力测试下,股内侧肌、股直肌和股外侧肌的表面肌电图,并记录KOA组受试者股内侧肌、股直肌和股外侧肌肌肉厚度与膝痛程度,以评估肌电数据和临床指标的相关性。结果：KOA患者和健康受试者在各不同角速度60°/s(P<0.001)、90°/s(P<0.01)、180°/s(P<0.01)膝关节屈伸运动中屈膝最大力矩与伸膝最大力矩均具有显著性意义,且KOA组膝关节屈伸最大力矩平均值均低于CON组。在角速度为60°/s等速肌力测试时,KOA组股外侧肌的中值频率差值率（P<0.05）、股直肌的均方根值（P<0.01）与相应对照组具有显著性意义;在角速度为90°/s等速肌力测试时,两组受试者的股直肌均方根值存在显著性差异（P<0.05）;在角速度为180°/s时,两组的股直肌中值频率差值率（P&...     

髌骨软化症患者膝关节等速肌力测试

目的 分析髌骨软化症患者膝关节周围肌力特征,并比较其与健康人的差异。方法 2021年3月,采用等速肌力测试与训练系统,对70例单膝发病髌骨软化症患者(观察组)和35例健康人(对照组)进行膝关节不同角速度(60°/s和180°/s)的屈、伸等速肌力测试。结果 60°/s和180°/s时,观察组患侧屈、伸肌峰力矩、峰力矩体质量比、总功均显著低于对照组(U> 1097.0,P <0.001);观察组患侧60°/s屈、伸肌和180°/s时伸肌峰力矩、峰力矩体质量比、总功均低于观察组健侧(|Z|> 2.121, P <0.05)。60°/s和180°/s时,观察组患侧屈伸肌力比值均明显大于健侧和对照组(U> 1810.0,|Z|>3.691, P <0.01)。结论 髌骨软化症患者的患膝屈、伸肌肌爆发力和耐力均减弱,膝关节肌力存在失衡现象。     

膝骨关节炎患者股四头肌功能水平及髋关节步态运动学特征分析

目的:观察中老年膝骨关节炎(KOA)患者股四头肌功能水平及步行过程中髋关节的运动学特征。方法:选取18例KOA患者为KOA组,8例无KOA者为对照组,2组的年龄、身高、体重和身体质量指数(BMI值)相匹配。2组受试者均进行等速肌力测试、无线表面肌电测试及步态测试,测试及比较2组股四头肌峰力矩(PT值)、股内侧肌(VM)、股外侧肌(VL)和股直肌(RF)的积分肌电值(iEMG)、均方根值(RMS)、平均功率频率(MPF)及峰值髋内收、外展角度等和步行中髋关节的运动学特征,将股四头肌肌力与髋关节运动学特征进行相关性分析。结果:KOA组股四头肌等长和等速运动时PT值较对照组显著下降(P<0.01),VL在60°/s等速收缩时表面肌电信号RMS值显著高于对照组(P<0.05),RF在180°/s等速收缩时表面肌电信号RMS值显著高于对照组(P<0.01),步行时峰值髋关节内收及外展角度显著低于对照组(P<0.05),股四头肌肌力与髋关节运动学特征无相关。结论:KOA组较对照组股四头肌肌力显著降低,活动时神经支配效率显著下降,且步行过程中峰值髋内收、外展角度显著减少,股四...     

肌内效贴对女性大学生膝关节肌力的影响

目的探讨肌内效贴扎对青年女性膝关节肌力的影响。方法 20名健康女大学生,用等速测试仪,以60°/s角速度,测量无贴扎、肌内效贴扎、安慰贴扎3种状态下的膝关节屈伸向心性收缩及离心性收缩相对峰力矩;用表面肌电图测试股内侧肌、股直肌、股外侧肌的肌电振幅均方根值(RMS)。结果向心性收缩时,肌内效贴扎时伸肌相对峰力矩明显高于无贴扎、安慰贴扎时(P0.01),屈肌相对峰力矩3种状态下无显著性差异(P0.05);股内侧肌在肌内效贴扎时RMS标化值明显低于未贴扎时(P0.01);股外侧肌肌内效贴扎时RMS标化值明显低于未贴扎时、安慰贴扎时(P0.01);股直肌RMS标化值3种状态下无显著性差异(P0.05)。离心性收缩时,肌内效贴扎时伸肌、屈肌相对峰力矩均明显高于无贴扎、安慰贴扎时(P0.01);股内侧肌、股外侧肌在肌内效贴扎时RMS标化值低于未贴扎时(P0.01);股直肌RMS标化值3种状态下无显著性差异(P0.05)。结论肌内效贴扎可以提高股四头肌向心性、离心性收缩肌力,增加腘绳肌离心性收缩肌力,提高股内侧肌及股外侧肌的肌纤维募集能力。     

等速运动在膝关节创伤康复中的临床效果

目的:观察等速运动在膝关节创伤康复中的临床效果。方法:选取2017年1~12月我院收治的患有单侧膝关节创伤的20例患者作为观察组,20例正常人作为对照组,观察组给予膝关节屈曲范围和屈伸肌肌力等速训练,对照组只进行常规训练,不采取其他任何干预措施,观察两组训练前后膝关节屈肌峰力矩与伸肌峰力矩在60°/s、120°/s、180°/s测试速度下存在的差异。结果:训练前观察组患侧膝关节屈肌峰力矩与伸肌峰力矩在60°/s、120°/s、180°/s的测试速度下与本组健侧和对照组比较存在明显差异,具有统计学意义(P0.05);训练后观察组患侧膝关节屈肌峰力矩与伸肌峰力矩在60°/s、120°/s、180°/s的测试速度下与健侧及对照组比较无明显差异,不具有统计学意义(P0.05)。结论:采用等速运动治疗患有膝关节创伤的患者,提高了康复治疗的效果,改善患者患侧膝关节的屈肌峰力矩与伸肌峰力矩,取得了理想的临床效果。     

髌股关节炎患者膝周肌群表面肌电信号特征研究

目的:观察髌股关节炎患者膝周肌群肌肉功能和协调活动差异,及其与膝关节疼痛的关系.方法:选择20例髌股关节炎患者,记录屈膝90°最大等长收缩(MVIC)、下蹲和站起时,双侧股外侧肌、股内侧肌、股二头肌和半腱肌的表面肌电图.计算均方根值(RMS)和协同收缩率(CCR),并观察CCR与疼痛的关系.将单膝患病患者健侧及双膝患病...     

肌内效贴对离心收缩诱发的踝关节肌肉疲劳后的肌力和平衡能力的影响

目的:探讨肌内效贴贴扎对离心运动诱发的踝关节周围肌群疲劳后肌肉力量以及静态平衡能力的即刻影响。方法:受试对象为45名健康男性大学生,将受试者随机分成3组各15例进行不同测试(正常组、肌肉疲劳组以及肌内效贴组)。其中,正常组直接进行肌力与平衡测试;肌肉疲劳组在BIODEX等速训练仪的离心/离心的训练方式下进行连续的踝背伸及跖屈进而诱导肌肉疲劳,当疲劳出现时立即进行肌力与平衡测试;肌内效贴组采用与肌肉疲劳组相同的训练方法,在疲劳后即刻接受肌内效贴贴扎随后进行肌力与平衡测试,包括：向心模式60°/s和180°/s速度下的等速肌力和睁眼/闭眼状态下的静态平衡测试。结果:在等速肌力方面,肌肉疲劳组60°/s与180°/s跖屈、背伸各项肌力指标均较正常组降低(均P<0.05);肌内效贴组60°/s跖屈峰力矩与平均功率、60°/s背伸峰力矩、平均峰力矩、平均功率均较肌肉疲劳组增加(均P<0.05)。180°/s跖屈平均峰力矩、背伸平均峰力矩、平均功率均较肌肉疲劳组增加(均P<0.05),肌内效贴组背伸峰力矩较正常组降低(P<0.05)。在静态平衡方面,在睁眼状态下肌肉疲劳组Y...     

脑卒中偏瘫患者股直肌和股二头肌的表面肌电信号特征

目的：观察脑卒中偏瘫患者在最大等长收缩（MIVC）时股直肌和股二头肌的表面肌电信号特征，为脑卒中患者的康复提供客观依据。方法：选择26例恢复期的脑卒中患者，在进行膝关节屈、伸肌群的MIVC时检测并记录股直肌和股二头肌的表面肌电信号，并计算积分肌电图（iEMG）和协同收缩率等。结果：在MIVC状态下，膝伸展时，健侧股直肌的iEMG大于患侧，差异有显著性意义（P〈0．05）；健、患侧股二头肌的iEMG比较，差异无显著性意义（P〉0．05）。膝屈曲时，健侧股二头肌的iEMG大于患侧，差异有显著性意义（P〈0．05），患侧股直肌的iEMG大于健侧，差异有显著性意义（P〈0．05）。患侧膝屈曲的协同收缩率大于健侧，差异有显著性意义（P〈0．05），而患侧膝伸展的协同收缩率与健侧比较，差异无显著性意义（P〉0．05）。结论：脑卒中偏瘫患者膝关节痉挛以伸肌群为主，对膝关节屈肌群和伸肌群收缩的协调性训练，尤其在膝关节屈曲运动时，增强主动肌收缩，抑制拮抗肌的协同收缩，应是脑卒中患者下肢康复的重要目标。     

健康青年下台阶时股内侧肌、股直肌和股外侧肌间的表面肌电变化

目的探讨健康青年下台阶时股内侧肌、股直肌及股外侧肌的肌肉收缩强度差异。方法 2016年,选取首都医科大学2015级30名健康在校大学生,将电极贴于优势侧股四头肌上,采集受试者下台阶过程中的股内侧肌、股直肌及股外侧肌的肌电信号。结果在下台阶过程中,股直肌的最大收缩幅值和平均收缩幅值显著小于股内侧肌和股外侧肌(P0.001);而股内侧肌和股外侧肌无显著性差异(P0.05)。结论健康青年在下台阶过程中股内侧肌及股外侧肌的活性显著高于股直肌;股内侧肌与股外侧肌协同收缩活性相当。     

太极拳特定动作下股内侧肌和股外侧肌表面肌电特征的研究

目的 研究太极拳特定动作中股内侧肌(VMO)和股外侧肌(VL)的肌纤维募集情况.方法 收集15名健康志愿者在维持5个太极拳定势(白鹤亮翅、金鸡独立、搂膝拗步、十字手、仆步)时VL、VMO的表面肌电信号,比较平均肌电值(AEMG)、平均功率频率(MPF)、中位频率(MF)、零点通过率(ZCR).结果 维持白鹤亮翅、金鸡独立时,其支撑脚VMO、VL的所有指标均无显著性差异;维持搂膝拗步、十字手、仆步时,其支撑脚VL的AEMG、MFC、ZCR、MF均小于VMO(P<0.05);与股四头肌的最大随意收缩负荷相比,所测试的动作下,肌肉负荷属于中小负荷,并且能募集到更多的慢肌纤维.结论 进行太极拳运动时,肌肉负荷较小,并且能募集到更多的慢肌纤维;某些太极拳动作下,VMO可以较多地募集到肌纤维.     

Spinal Reflex Arc Excitability Corresponding to the Vastus Medialis Obliquus and Vastus Medialis Longus Muscles

[Purpose] The gross morphology of the vastus medialis (VM) muscle has been thoroughly described. However, there is insufficient evidence of physiological differentiation between the VM obliquus (VMO) and VM longus (VML). To elucidate spinal reflex arc excitability in two divisions of the VM, we compared H-reflexes and T-waves in VMO and VML. [Subjects] Twenty-three healthy male volunteers participated in this study. [Methods] The H-reflex was evoked from the VMO and VML by electrical stimulation of the femoral nerve during knee extension at 10% maximal voluntary isometric contraction. Also, the patellar tendon was tapped by an examiner using an electrical tendon hammer, and a component of the compound muscle action potential (T-wave) was recorded. [Results] The configurations of the H-reflex and T-wave were sharp and slow in VMO and VML, respectively. No significant differences in the amplitudes of the H-reflexes and T-waves were observed between VMO and VML. The durations of VML H-reflexes and T-waves were significantly longer than those in VMO. [Conclusion] Spinal reflex arc excitability corresponding to VMO and VML was similar. However, the configurations and durations of the H-reflex and T-wave were differentiated with electromyography. On the basis of these findings, we suggest that VMO and VML are electrophysiologically distinct entities.Key words: Vastus medialis, H-reflex, T-wave     

Activities of the Vastus Lateralis and Vastus Medialis Oblique Muscles during Squats on Different Surfaces

[Purpose] The purpose of the present study was to examine the effects of squat exercises performed on different surfaces on the activity of the quadriceps femoris muscle in order to provide information on support surfaces for effective squat exercises. [Subjects and Method] Fourteen healthy subjects performed squat exercises for five seconds each on three different support surfaces: hard plates, foam, and rubber air discs. Their performance was measured using electromyography. As the subjects performed the squat exercises on each surface, data on the activity of the vastus medialis oblique and the vastus lateralis, and the vastus medials oblique/vastus lateralis ratio, were collected. [Results] The activity of the vastus medialis oblique and the vastus medialis oblique/vastus lateralis ratio were found to be statistically significantly higher on rubber air discs than when the squats were performed on hard plates or foam. [Conclusion] To activate the vastus medialis obilique, and to enhance the vastus medialis oblique/vastus lateralis ratio, unstable surfaces that are highly unstable should be selected.Key words: Support surfaces, Vastus medialis obilique, Vastus lateralis     

Effects of Open and Closed Kinetic Chains of Sling Exercise Therapy on the Muscle Activity of the Vastus Medialis Oblique and Vastus Lateralis

[Purpose] The muscle strength of the quadriceps muscle is critical in patellofemoral pain syndrome. The quadriceps muscle supplies the power for dynamic patellar movement, and the vastus medialis oblique (VMO) and vastus lateralis (VL) enable the patella to stabilize during tracking. We followed the theories about open and closed kinetic chain exercises to design two exercises, sling open chain knee extension (SOCKE) exercise and sling closed chain knee extension (SCCKE) exercise. The purpose of our study was to research the changes in quadriceps muscle activity during both exercises. [Methods] Electromyographic analysis was used to explore the different effects of the two exercises. The MVC% was calculated for the VMO and VL during exercise for analysis. [Results] We found that the mean MVC% values of the VMO and VL during the SOCKE exercise were higher than those during the SCCKE exercise. The ratio of the VMO to VL was 1.0 ± 0.19 during the SOCKE exercise and 1.11 ± 0.15 during the SCCKE exercise. [Conclusions] The SOCKE exercise is targeted at quadriceps muscle training and has a recruitment effect on the VMO. The beneficial effect of the SOCKE exercise is better than that of the SCCKE exercise.Key words: Patellofemoral pain syndrome, Sling exercise therapy, Electromyography     

The Effect of Self-Myofascial Release on the Pennation Angle of the Vastus Medialis Oblique and the Vastus Lateralis in Athletic Male Individuals: An Ultrasound Investigation

BackgroundMaintenance of patellar stability requires a balance between the vastus medialis oblique (VMO) and the vastus lateralis (VL). The imbalance between these muscles is thought to be implicated in the etiology of patellofemoral pain (PFP). Where there is hypertrophy of the VL in PFP patients, self-myofascial release (SMR) may be utilized for its management. However, there is no current evidence regarding SMR and its effects on VMO and VL architecture. The aim of this study, therefore, was to use ultrasound to gain further understanding of the effects of a program of SMR on the fiber angles of the VMO and VL.HypothesisThere will be a significant decrease in the pennation angles of the VMO and VL after seven weeks of SMR using a foam roller.Study DesignCohort StudyMethodsTwenty-five young, athletic, male participants were recruited to use a foam roller, along the full length of both anterior thighs, three times weekly, on three separate days, for seven weeks. Ultrasound was used to determine the initial and final VMO and VL pennation angles on both limbs. One eligible participant was chosen as an intra-rater control and did not partake in the SMR regimen.ResultsThere was a statistically significant (p < 0.001) decrease in the pennation angles of the VMO and VL after the SMR regime. Mean combined right and left VL angle change was -6.65° (-18% mean change) and the mean combined right and left VMO angle change was -7.65° (-11.5% mean change). A weak negative correlation was found between initial VMO fiber angle and the angle change (Rsquared = -0.21), as well as moderate negative correlation for the VL (Rsquared = -0.51).ConclusionA program of SMR on the anterior thighs of young, asymptomatic males resulted in changes to the fiber angles of both the VMO and VL. There was a significant decrease in pennation angle after seven weeks of SMR using a foam roller.     

Vastus lateralis oxygenation and blood volume measured by near-infrared spectroscopy during whole body vibration

The purpose of this study was to investigate the effects of whole body vibration (WBV) on oxygenation of vastus lateralis muscle during squatting exercise. Eighteen male subjects [mean age, 27.3 +/- 6.0 (SD) years; mean height, 171.8 +/- 4.9 cm; mean weight, 64.4 +/- 6.1 kg] performed squatting exercise on a vibration platform for 3 min with and without vibration, and changes in oxygenation of the vastus lateralis muscle were determined by near-infrared spectroscopy. The muscle oxygenation levels and total haemoglobin and myoglobin levels (total Hb/Mb) decreased during squatting exercise with and without vibration. After exercise, the muscle oxygenation level and total Hb/Mb rapidly increased from the minimum value during exercise and remained constant for latter 10 min. The muscle oxygenation levels with vibration from 90 to 180 s after the start of squatting exercise were significantly lower than those without vibration. Total Hb/Mb with vibration from 90 s after the squatting exercise to 540 s were significantly higher than those without vibration. This study demonstrated that WBV exercise affects the oxygenation level of vastus lateralis muscle and reduces muscle oxygenation level compared to that with no WBV. Therefore, WBV exercise may be an efficient training stimulus for muscle deoxygenation.