太极拳运动中上肢肌肉工作特点的研究

目的本文通过肌电测试仪测试太极拳运动中几个典型的上肢基本动作肌电值,与BIODEX等速训练仪器上最大力运动肌电值进行比较,试图了解太极拳运动中上肢肌肉工作的形式与特点,为从生理学角度深入研究太极拳运动的生物学机制提供实验依据和参考,为深入研究太极拳和轮椅太极拳的健身机制提供新的思路和方法。方法武术专业学生15名,(10男5女),选取太极拳运动上肢典型的步型和手型共6个动作,用Megawin2000表面肌电测试系统记录各动作的主要部位肌肉的积分肌电值(IEMG),然后再记录每位受试者在Biodex等速训练仪上肢肩关节三角肌三个维度最大力等速运动时的IEMG,对比分析前者和后者的积分肌电(IEMG)值和平均功率频率(MPF)值。结果太极拳上肢运动时,上肢进行野马分鬃动作时三角肌的IEMG(0.553mV o sec),为相应维度BIODEX等速训练仪上最大力IEMG(3.986mV o sec)的13%,是全部测定数据的最小百分比;上肢肌进行单边作时三角肌的IEMG(0.771mV o sec)为相应维度BIODEX等速训练仪上最大力IEMG(2.733mV o sec)的28%,是全部测定数据的最大百分比;所有IEMG比值在13~28%之间。太极拳上肢运动MPF值显著低于最大收缩时的MPF(P0.01)。结论太极拳上肢运动时,运动负荷强度为最大负荷的13%~28%,属于中低强度负荷。肌电信号频率特征MPF值提示,太极拳上肢运动时肌肉是以慢肌运动单位参与为主。太极拳上肢运动的中低强度、慢肌运动单位参与为主的运动特点,为轮椅太极的健身效果提供了依据。     

功能性游离肌肉移植重建部分上肢功能的临床应用

目的　探讨应用3种功能性游离肌肉移植重建部分上肢功能手术的疗效,结合相关解剖基础分享临床经验。 方法　2010年1月至2018年12月,应用功能性游离股薄肌、背阔肌、胸小肌移植重建上肢功能手术治疗患者39例,包括重建屈肘和屈指功能6例,屈指功能11例,拇对掌功能22例。根据肢体情况选择不同的动力神经和供血血管,术中调节移植肌肉于最佳肌张力水平,重建移植肌肉的神经和血运。 结果　功能性游离肌肉完全成活37例,重建的上肢功能恢复良好,优、良率达94.8%;重建功能未恢复者2例,其中1例出现移植肌肉和皮瓣部分坏死。 结论　应用功能性游离股薄肌、背阔肌和胸小肌移植重建上肢功能手术效果满意,是治疗各种原因导致的上肢肌肉缺损及严重肢体障碍的有效方法。     

神经肌肉电刺激对躯干稳定肌影响的研究进展

该文从神经肌肉电刺激作用于躯干稳定肌的效果与参数及对不同人群的应用效能等角度,阐述了躯干稳定肌的组成与功能,以及神经肌肉电刺激招募躯干稳定肌的作用机制与参数,并分析探讨了其临床效果。未来的临床研究可能集中在健康人群的长期随访队列研究和运动损伤人群躯干稳定肌萎缩的机制与临床研究方面,同时神经肌肉电刺激联合运动康复的研究也是发展趋势。该文预判相关便携式NMES设备的研发与应用具有较大的临床意义。     

血流限制训练对上肢肌肉适能效益的影响

背景：血流限制训练在提高肢体肌肉力量方面有广阔的应用前景,其中上肢应用血流限制训练的效果较为理想,且具体应用方案具有较高的研究价值。目的：阐述血流限制训练对上肢肌肉适能效益的影响,总结上肢应用血流限制训练的具体方案,试图依据现有研究给出应用方案的建议。方法：检索中国知网(CNKI)、万方、维普、CBM、PubMed、 Embase、EBSCO、Cochrane Library及Web of Science数据库中发表的上肢应用血流限制训练的相关文献,中文检索词为“血流限制,血流限制训练,加压训练,上肢,上臂,前臂,手臂,小臂”,英文检索词为“Blood Flow Restriction Training,Blood Flow Restriction Exercise,Blood Flow Restriction Therapy,BFR Therapy,Occlusion training,KAATSU training,BFRT,Upper Extremity,Upper Limb,Arm,Forearm”。选择各数据库建库至2022年12月收录的上肢应用血流限制训练的相关文章,并根据...     

神经肌肉电刺激模拟肌肉力量训练的生物力学研究

基于对电刺激模拟肌肉力量训练的理论与实践研究，结果表明：神经肌肉电刺激（NMES）的训练效果显著优于肌肉直接电刺激（MES），肌肉力量素质的增长与电刺激方式和刺激源的电特性有关；NMES能以较低的体能消耗完成肌肉力量的训练，适合作为常规训练前，中、后的辅助训练手段，NMES模拟肌肉力量训练的方式能满足肌肉功能群协调能力的同步发展。     

前臂背侧逆行皮瓣修复腕部电烧伤

目的 总结临床应用前臂背侧逆行皮瓣修复腕部电烧伤创面的手术经验,为临床治疗提供参考资料.方法 选取2011年11月至2012年11月内蒙古包钢医院烧伤科收治的腕部电烧伤患者13例,入院后及时给予手术清创、探查尺桡动脉损伤程度,以前臂背侧逆行皮瓣修复腕部电烧伤创面.结果 13例腕部严重电烧伤患者所有皮瓣均成活,仅3例皮瓣下轻度感染给予换药或再次手术封闭创面后愈合,其余10例全部一期修复.结论 尽可能早期应用前臂背侧逆行皮瓣修复腕部严重电烧伤创面是一种可行方法,可以最大限度恢复电烧伤部位外形和功能,减少创面愈合时间.     

肌电生物反馈疗法联合综合康复训练对老年脑梗死偏瘫患者上肢运动功能的效果

目的 探讨肌电生物反馈疗法联合综合康复训练对老年脑梗死偏瘫患者上肢运动功能的疗效。方法 选择2021年1月至2021年12月九江市第一人民医院老年医学科收治的80例脑梗死后遗偏瘫的老年患者,性别不限,年龄60～80岁。按照入院先后顺序分为观察组和对照组,每组40例。对照组接受综合康复训练治疗,观察组在对照组的基础上加用肌电生物反馈疗法,比较两组系统康复治疗后三角肌、肱三头肌、前臂伸肌最大收缩时的肌电信号幅度水平、Fugl-Meyer上肢运动功能评分(FMA)与患肢活动度。结果 训练后,两组三角肌、肱三头肌、前臂伸肌最大收缩时的肌电图波幅、FMA评分及患肢的外展、外旋、内旋角度均较训练前升高(P<0.05),与对照组比较,观察组以上指标更高(P<0.001)。结论 对于老年脑梗死偏瘫患者的康复治疗,可在综合康复训练基础上加用肌电生物反馈疗法,能够更好地帮助患者重建上肢运动功能。     

上肢电烧伤63例的外科整复治疗

上肢电接触伤和电弧烧伤６３例，手术治疗４５例（７３次手术）。采用皮瓣修复２６例，其中局部、岛状、远位皮瓣４１个；１９６２～１９８０年１９例伤后清创包扎、换药，待坏死组织与正常组织界线明显后，再切除坏死组织或截肢（指）覆盖创面。１９８１～１９９１年治疗４４例。两种治疗方法截肢（指）率差异显著（Ｘ２＝４．７０９，Ｐ＜０．０５）     

屈腕肌移位重建前臂旋后功能的应用解剖及临床应用

目的:探索重建前臂旋后功能的动力肌,并在临床应用中验证其功能效果。方法:采用50例尸体上肢,经灌注后进行解剖、测量,观察尺侧腕屈肌和桡侧腕屈肌大体形态、血液供应及神经支配规律性,并设计临床手术方法,修复8例由于臂丛神经损伤后遗前臂旋后功能障碍,其中使用尺侧腕屈肌3例,桡侧腕屈肌5例。结果:8例平均随访3.6年,前臂总旋转活动度为125°～165°.旋后肌力为Ⅲ~ ～Ⅵ级。均能完成日常生活及工作,对屈腕功能无明显影响。结论:尺侧或桡侧腕屈肌移位重建前臂旋后功能。均能达到良好功能恢复。     

人前臂多肌腱肌肉的形态特点、神经分布及肌内腱板特征

目的:观察人前臂多肌腱肌肉的形态特点、神经分布及其横断面内肌内腱板或纤维隔的特征,探讨其在手指运动中的作用.方法:在SXP-1C型手术显微镜下,解剖、观察前臂多肌腱肌肉的神经分支来源、分布及其横断面内的肌内间隔.结果:前臂多肌腱肌肉在起始处与毗邻肌肉的肌腹相结合,远侧分为4个相对独立的肌束,并逐渐移行至第2～5指肌腱.4个肌束之间分界不清,但至示指肌束相对独立.支配多肌腱肌肉的神经主干通常超过4支,并在不同部位穿入肌束.多肌腱肌肉的横断面显示,肌腹内存在不完全分隔4个肌束的肌内腱板或纤维隔.结论:前臂多肌腱肌肉的形态、神经分布及其内肌内腱板或纤维隔状况与第2～5指独立运动的局限性相关,肘前区和前臂近侧的手术应注意避免损伤正中神经至前臂的分支.     

Effect of local leg cooling on upper limb trajectories and muscle function and whole body dynamic balance

This study was designed to find out if local leg cooling affects muscle function and trajectories of the upper limb during repetitive light work as well as capability to maintain dynamic balance. Nine healthy female subjects performed repetitive lifting task with right hand for 60 min while standing in front of a table with six target angles (30°–220°) and with the legs inside a container with 15°C cold water (Cold condition, C) or without water (Normal condition, N). Muscle temperature of the medial aspect of the gastrocnemius, rectal, and skin temperatures were measured continuously. The trajectories of the right upper limb were recorded with a 3D motion analysis system. Muscular strain (averaged EMG, a-EMG) and EMG gaps in eight muscles of the right upper limb were measured. End point excursion depicting the ability to maintain dynamic balance was measured before and after each experiment. Leg cooling decreased significantly (P < 0.05) the muscle and the mean skin temperature in C compared with N (6.7 and 2.2°C, respectively). No marked changes in the trajectories or EMG activity were observed between the different environmental conditions. The end point excursion was significantly (P < 0.05) reduced in C compared with N and a positive correlation between excursion and muscle temperature was found at the end of the working period in C. In conclusion, local leg cooling did not affect upper limb muscle function or trajectories, but ability to maintain dynamic balance was reduced.     

Perceptual and motor effects of agonist-antagonist muscle vibration in man

Summary Perceptual and motor effects of vibration applied simultaneously to the distal tendons of the Biceps and Triceps muscles, in isometric conditions and without sight of the stimulated arm, have been studied in human volunteers. Motor effects, measured by surface EMG, are inexistent when the flexor and extensor muscles are simultaneously vibrated at the same frequency. However, EMG activity appears in the muscle being vibrated at the lower frequency when simultaneous vibration is applied at different frequencies. The sensations felt by the subjects were reproduced by the nonvibrated arm and recorded by a goniometer. The studies show that the velocity and the amplitude of the ilusory movement is related to the difference in vibration frequency applied to the two muscles. The direction of movement felt (flexion or extension) is that produced by shortening of the muscle being vibrated at the lower frequency. When the two vibration frequencies are the same, there is either no sensation of movement, or a sensation of very slow movement. These results support the notion that the sensation of movement at a joint may be derived from a central processing of the proprioceptive inflow data obtained from flexor and extensor muscles. This interpretation may also be valid for the results obtained earlier by vibration of a single muscle. Furthermore, it is coherent with data on spindle afferent fibres obtained by microneurography in man during passive or active movements.This work was supported by grants from the Ministère de l'Industrie et de la Recherche     

The effects of wrist muscle vibration on human voluntary elbow flexion-extension movements

Summary The effect of forearm muscle tendon vibration during alternating step flexion-extension movements about the elbow was studied in normal humans. In one experiment, a vibrator was mounted over either the forearm flexor or the extensor muscle. In a second experiment, a vibrator was mounted over either the forearm muscle or the biceps muscle. In both experiments, vibration was applied either to a single muscle or simultaneously to both muscles during elbow flexion-extension movements. After a period of practice, subjects learned the required movements and were able to make them with their eyes closed. Application of vibration to the forearm and the biceps muscle during extension movements produced an undershoot of the required end movement position. Moreover, application of high frequency vibration (100 Hz) to the forearm extensor and flexor muscle produced an overshoot of the required end-movement position. The observed results are consistent with vibration induced activation of muscle spindle receptors not only in the lengthening muscle during movement but also in the forearm muscles. It is suggested that the pattern of distribution of muscle spindle afferent from the forearm muscle onto -motoneurons of muscles acting at the elbow has played an important role of alternating step flexion-extension movements.     

Coherence analysis of muscle activity during quiet stance

Studies of muscle activation during perturbed standing have demonstrated that the typical patterns of coordination (“ankle strategy” and “hip strategy”) are controlled through multiple muscles activated in a distal-to-proximal or proximal-to-distal temporal pattern. In contrast, quiet stance is thought to be maintained primarily through the ankle musculature. Recently, spectral analysis of inter-segment body motion revealed the coexistence of both ankle and hip patterns of coordination during quiet stance, with the predominating pattern dependent on the frequency of body sway. Here we use frequency domain techniques to determine if these patterns are associated with the same muscular patterns as observed during perturbed stance. Six of the seven muscles measured showed a linear relationship to the sway of at least one body segment, all being leg muscles. Muscle–segment phases were consistent with that required to resist gravity at low frequencies, with increasing phase lag as frequency increased. Visual information had effects only at frequencies below 0.5 Hz, where the shift from in-phase to anti-phase trunk–leg co-phase was observed. These results indicate that co-existence of the ankle and hip pattern during quiet stance involves only leg musculature. Anti-phase movement of the trunk relative to the legs at higher frequencies arises from indirect biomechanical control from posterior leg muscles.     

Effects of cooling and clothing on vertical trajectories of the upper arm and muscle functions during repetitive light work

The present study was designed to find out if cooling and/or clothing affect the vertical trajectories and muscle function of the upper arm during repetitive light work. Twelve female subjects performed a one-handed lifting task for 60 min while standing in front of a table with six target angles (30 degrees to 220 degrees ). The experiment was carried out in a climatic chamber in three different conditions: at 10 degrees C (C), at 25 degrees C (TN), and at 10 degrees C dressed in cold-protective clothing (C(p)). Skin and rectal temperatures were measured continuously. The vertical trajectories of the head, shoulder, elbow, and wrist on the right side of the body were recorded. Muscular strain (averaged EMG, a-EMG) and EMG gaps in eight muscles on the right upper arm were measured. The variation of the vertical trajectory amplitude of the upper arm measured from the elbow was significantly higher (at 200 degrees ) both at C and C(p) (50 and 25% respectively) and in shoulder (at 220 degrees angle) at C (33%) compared with TN (P < 0.05). Both C and C(p) increased a-EMG and reduced the number and duration of EMG gaps significantly in all muscles studied. In conclusion, in repetitive tasks the high mean vertical trajectory and changes in the amplitude of the trajectory of the upper arm at C and C(p) compared with TN were associated with increased muscular strain and reduced number of EMG gaps (more continuous activation of given muscle fibers). The changes in trajectories may serve as indicator of a risk for local muscle fatigue.     

Comparison between the effects of chronic and acute hypoxaemia on muscle afferent activities from the tibialis anterior muscle

The reflex loops initiated by the activation of muscle afferents are altered by a reduction of the oxygen supply. This has been shown in different mammalian species under experimental conditions of acute or chronic hypoxaemia. In the present study in rats, we compared the effects of acute and chronic hypoxaemia on the activity of afferents from the tibialis anterior muscle to investigate the existence of possible adaptive mechanisms to hypoxaemia. The activity in groups I and II (mechanosensitive) and groups III and IV (mechano- and mostly chemosensitive) muscle afferents was recorded under conditions of normoxaemia and acute and chronic hypoxaemia. Chronic hypoxaemia was achieved by exposing the rats for 45 consecutive days to a gas mixture containing 10% oxygen in nitrogen, whereas acute hypoxaemia was limited to a 1-h exposure to a 10% oxygen mixture. Different test agents: muscle stimulation (MS), arterial injection of KCl or lactic acid and tendon vibrations, were used to activate muscle afferents. Both acute and chronic hypoxaemia suppressed the post-MS activation of groups III and IV muscle afferents and significantly depressed the response of these afferents to KCl and lactic acid. The pattern of response of mechanosensitive afferents to mechanical tendon vibration was similar under the three conditions but chronic hypoxaemia significantly reduced the response to 10–50 Hz vibrations. We conclude that inhibitory effects on muscle metabosensitive afferents occurred in the first minutes following acute hypoxaemia and was prolonged with chronic hypoxaemia. Our data also suggest that chronic hypoxaemia depresses mechanosensitive muscle afferents. This may explain the observation that sensorimotor control of skeletal muscles is often markedly impaired in hypoxaemic humans. Electronic Publication     

肘关节运动肌的构筑学研究

对12侧人肘关节运动肌的构筑进行了研究。结果表明，肱三头肌的生理横切面积是屈肘肌的1．9倍（41．56与21．69cm2），表明它比屈肘肌具有更大肌力。根据肌纤维长度的差异，肘屈肌的收缩速度应比肱三头肌快60％左右。由于肱三头肌的快缩纤维比例较大（60％），再加肘关节的杠杆装置，肱三头肌的伸肘速度应可与屈肌相匹配。旋前和旋后运动的肌力大致相等、旋前圆肌、旋后肌、肘肌和肱桡肌的生理横切面积合计达22．10cm2，比屈肘肌的肌力还大，我们认为它们对稳定肘关节有重要作用。本文对人类肘关节运动肌的进化特征进行了讨论。     

Gaze direction effects on perceptions of upper limb kinesthetic coordinate system axes

The effects of varying gaze direction on perceptions of the upper limb kinesthetic coordinate system axes and of the median plane location were studied in nine subjects with no history of neuromuscular disorders. In two experiments, six subjects aligned the unseen forearm to the trunk-fixed anterior-posterior (a/p) axis and earth-fixed vertical while gazing at different visual targets using either head or eye motion to vary gaze direction in different conditions. Effects of support of the upper limb on perceptual errors were also tested in different conditions. Absolute constant errors and variable errors associated with forearm alignment to the trunk-fixed a/p axis and earth-fixed vertical were similar for different gaze directions whether the head or eyes were moved to control gaze direction. Such errors were decreased by support of the upper limb when aligning to the vertical but not when aligning to the a/p axis. Regression analysis showed that single trial errors in individual subjects were poorly correlated with gaze direction, but showed a dependence on shoulder angles for alignment to both axes. Thus, changes in position of the head and eyes do not influence perceptions of upper limb kinesthetic coordinate system axes. However, dependence of the errors on arm configuration suggests that such perceptions are generated from sensations of shoulder and elbow joint angle information. In a third experiment, perceptions of median plane location were tested by instructing four subjects to place the unseen right index fingertip directly in front of the sternum either by motion of the straight arm at the shoulder or by elbow flexion/extension with shoulder angle varied. Gaze angles were varied to the right and left by 0.5 radians to determine effects of gaze direction on such perceptions. These tasks were also carried out with subjects blind-folded and head orientation varied to test for effects of head orientation on perceptions of median plane location. Constant and variable errors for fingertip placement relative to the sternum were not affected by variations in gaze direction or head orientation. Thus, the perceived position of the trunk-fixed median plane is not altered by varying gaze direction. The implications of these results for mechanisms underlying kinesthetic perceptions and their potential roles in programming of upper limb movements to visual targets are discussed.     

Changes in reciprocal and transjoint inhibition induced by muscle fatigue in man

The effects of localised muscle fatigue on group I reflex pathways were studied in the human upper limb. Activation of group I afferents originating from biceps and extensor carpi radialis (ECR) resulted in an inhibition of flexor carpi radialis (FCR) motoneurones, probably through a disynaptic pathway. Reciprocal inhibition (from ECR to FCR) and transjoint inhibition (from biceps to FCR) were compared before and during localised fatigue induced in the muscle from which group I afferents originated. Fatigue of wrist extensors did not modify the reciprocal inhibition, while during fatigue of elbow flexors the transjoint inhibition was less pronounced. This striking difference between reciprocal and transjoint inhibition is discussed in relation to the pattern of diffusion of voluntary contractions during fatigue in the human upper limb.     

Coordination of intrinsic and extrinsic hand muscle activity as a function of wrist joint angle during two-digit grasping

Fingertip forces result from the activation of muscles that cross the wrist and muscles whose origins and insertions reside within the hand (extrinsic and intrinsic hand muscles, respectively). Thus, tasks that involve changes in wrist angle affect the moment arm and length, hence the force-producing capabilities, of extrinsic muscles only. If a grasping task requires the exertion of constant fingertip forces, the Central Nervous System (CNS) may respond to changes in wrist angle by modulating the neural drive to extrinsic or intrinsic muscles only or by co-activating both sets of muscles. To distinguish between these scenarios, we recorded electromyographic (EMG) activity of intrinsic and extrinsic muscles of the thumb and index finger as a function of wrist angle during a two-digit object hold task. We hypothesized that changes in wrist angle would elicit EMG amplitude modulation of the extrinsic and intrinsic hand muscles. In one experimental condition we asked subjects to exert the same digit forces at each wrist angle, whereas in a second condition subjects could choose digit forces for holding the object. EMG activity was significantly modulated in both extrinsic and intrinsic muscles as a function of wrist angle (both p < 0.05) but only for the constant force condition. Furthermore, EMG modulation resulted from uniform scaling of EMG amplitude across all muscles. We conclude that the CNS controlled both extrinsic and intrinsic muscles as a muscle synergy. These findings are discussed within the theoretical frameworks of synergies and common neural input across motor nuclei of hand muscles.