非特异性慢性腰背痛飞行员与无症状飞行员之间腰部竖脊肌表面肌电特征比较（摘要）

目的非特异性慢性腰背痛飞行员与无症状飞行员之间腰部竖脊肌表面肌电特征比较,为飞行员非特异性慢性腰背痛患者的客观诊断提供依据。方法用芬兰MEGA公司ME6000一T8表面肌电仪测量43名非特异性慢性腰背痛飞行员与9名无症状飞行员腰部竖脊肌等长收缩与站立位屈伸运动时表面肌电。     

利用体表肌电评价飞行员头颈部防护装置防护效果的研究

目的 通过观察受试者使用飞行员头颈部防护装置(neck protection device,NPD)时颈部表面肌电信号(surface electromyographic signal,sEMG)变化探讨该装置的防护效果.方法 15名男性志愿者,在不戴装备、仅戴保护头盔、同时戴保护头盔和飞行员头颈部防护装置3种情况下,分别测量颈椎前屈0°、10°、20°、30°、40°、50°和最大限度时的sEMG;并通过在头盔下颏带上悬挂1个2.5 kg配重的方式模拟+Gz过载时颈部的受力情况,记录此时在有、无颈部防护装置情况下颈部前屈到最大限度时的sEMG;计算振幅均方根值(root mean square,RMS).结果 受试者颈部在不戴任何装备及仅戴飞行保护头盔两种情况下做前屈时,不同前屈角度时的体表肌电值差异有统计学意义(F=160.454、129.563,P＜0.01).与头部处于中和位(颈前屈0°)时相比,受试者不戴装备时颈前屈至30°时的sEMG达最大值(5.99±1.99)mV,戴飞行保护头盔颈前屈至40°时的肌电信号达最大值(10.14±3.80)mV.戴飞行保护头盔后颈部前屈20°～50°时的sEMG大于不戴装备时,且差异有统计学意义(P＜0.05).头盔下悬挂配重后sEMG进一步增大.在同时戴飞行保护头盔及NPD后,无论是颈前屈至各种角度还是增加配重后前屈至50°,颈肌sEMG与不戴装备相比差异均无统计学意义.结论 受试者在戴飞行保护头盔及悬挂配重时作颈前屈会导致颈部肌电活动强度显著增强,而NPD可显著减轻两种情况下时的颈肌负荷. Abstract： Objective To evaluate the protection effect of a neck protection device (NPD) by analyzing neck muscle surface electromyographic signal (sEMG) for pilot.Methods Fifteen male subjects were tested under three conditions that were with no equipment, wearing helmet, and wearing helmet plus NPD respectively.At first, subjects flexed their necks from 10° to ultimate degree.Then subjects performed same maneuvers with helmet or with helmet and NPD when a 2.5 kg extra weight was appended on chin belt of helmet for simulating +Gz load.Neck sEMG was measured in all tests and root mean square (RMS) of amplitude was calculated.Results When flexing without equipment or only with helmet subjects' neck sEMG showed significant difference (F-160.454, 129.563, P＜0.01).For the subjects without any equipment, their neck sEMG appeared peak (5.99±1.99) mV as flexing to 30° when referenced to neutral position of head.But for the subjects with helmet the neck sEMG peak appeared at 40° flexing (10.14±3.80) mV.Within the 20° to 50° flexing range, helmet resulted in significantly higher neck sEMG comparing to no load condition (P＜0.05).Extra weight drove the incensement of neck tension.However, there was no significant difference in neck sEMG activity when flexed to any degree with helmet and NPD or to 50° with the extra weight.Conclusions Neck sEMG significantly increases when subject flexed with helmet or with an extra weight.The NPD could abate subject's tension on neck when wearing helmet.     

健康飞行员体表胃电活动特征

目的 观察健康飞行员的胃电活动特征并与普通自愿者比较。方法 随机选择健康体检飞行员10名和健康普通自愿者10名。先记录空腹胃电30min，进试验餐后再记录餐后胃电30min。用谱分析方法计算胃电参数。结果 飞行员餐前后胃电主频率与普通自愿者无差别；飞行员餐事餐前胃电主功率比值和空腹状态正常胃电慢波是百分比明显高于普通自愿者（P＜0．05和P＜0．01）；飞行员餐前胃电主频率不稳定系数（DFIC）和主功率不稳定系数（DPIC）均明显低于普通自愿者（P＜0．01和P＜0．05）。结论 健康飞行员胃电活动的主功率和正常胃电节律明显增加。提示在评价飞行员胃电活动时其正常参考值可能要相应改变。     

中医综合疗法对青少年特发性脊柱侧凸患者肺功能及表面平均肌电比值的影响

目的 评价中医综合疗法(导引、推拿、小针刀)对青少年特发性脊柱侧凸(AIS)患者肺功能和表面平均肌电(AEMG)比值的影响.方法 120例AIS门诊患者随机分为中医治疗组(治疗组)和支具对照组(对照组).治疗组采用脊柱平衡导引(2次/d,40min/次,每天坚持直至骨骼发育成熟)、脊柱平衡推拿(3次/周,25min/次,12个月)及小针刀整体松解(1次/周,共10次)治疗.对照组采用Milwaukee支具治疗(22h/d,12个月).观察治疗前及治疗后12个月时的肺功能指标[肺活量(VC)、第1秒用力呼气容积占用力肺活量的百分比(FEV1/FVC)、每分钟最大通气量(Mw)]改变,治疗前及治疗后12、24个月时的Cobb角改变,治疗前及治疗后6、12、18、24个月时AEMG比值变化,并对各指标进行组间比较.结果 治疗后12个月治疗组和对照组Cobb角矫正率(分别为51.4％、47.8％)差异无统计学意义(p＞o.05),而治疗后24个月治疗组Cobb角矫正率(62.5％)明显高于对照组(34.7％,P＜0.05).与治疗前比较,治疗组治疗后12个月VC、FEV1/FVC、MVV明显升高(P＜0.05),而对照组治疗后12个月各指标均有不同程度下降(p＜0.05).治疗组治疗后6、12、18、24个月时AEMG比值持续降低并趋向于1,表明侧凸两侧的肌张力趋于平衡,而对照组比值AEMG比值逐渐增加,表明侧凸两侧的肌张力不平衡加剧.两组治疗中均未发生明显的不良反应.结论 基于改善AIS脊柱内外平衡失调的中医脊柱平衡法能显著改善肌力的不平衡,减轻侧凸,提高肺功能,值得推广应用.AEMG比值可用于评价AIS的治疗效果及评估侧凸的进展.     

歼击机飞行员左室心肌质量的研究

歼击机飞行员长期经受 GZ暴露或较高水平的持续性 GZ应激能否对左室心肌质量产生影响 ,尚不清楚。我们有意作些探讨 ,以便为军事航空医学健康鉴定提供参考依据。一、对象与方法1.对象 :1997年 1月～ 1998年 8月来我院健康体检、除外心血管疾病的健康男性歼击机飞行员 5 0名。年龄 2 5～ 42岁 ,飞行时数 40 0～ 2 2 2 2 h。选部队地勤健康男性 42名做对照组 ,年龄 2 3～ 45岁。2 .方法 :采用美国 HP10 0 0彩色多普勒超声诊断仪 ,探头频率 2 .5 MHZ。受检者取左侧卧位 ,于胸骨旁左室长轴切面 ,二尖瓣腱索水平 ,测量舒张末期室间隔厚度 (…     

肌电生物反馈治疗飞行人员紧张型头痛35例疗效观察（摘要）

目的观察肌电生物反馈治疗飞行人员紧张型头痛的疗效。方法诊断为紧张型头痛飞行员35例,采用JD/PW—5型生物反馈仪治疗,每天一次,每次20mh,治疗后根据头痛程度变化判断疗效。结果治疗后头痛明显减轻,与治疗前相比有非常显著性差异（P〈0.01）。     

慢性非特异性下背痛患者竖脊肌等长收缩时空间活动特征

目的:探讨慢性非特异性下背痛(CNLBP)患者与健康人进行腰背肌等长收缩时竖脊肌空间活动分布的差异.方法:选取CNLBP患者15例为实验组(34.95±8.73岁),健康人15名为对照组(30.50±7.84岁).采用Oswestry功能障碍指数(ODI)、疼痛视觉模拟评分(VAS)进行临床评估.采用高密度表面肌电(H...     

卡肌宁对大鼠复合肌肉动作电位的影响

目的 研究肌松药卡肌宁对大鼠术中复合肌肉动作电位（ＣＭＡＰ）的影响。方法 取ＳＤ大鼠１６只,实验组腹腔内注射卡肌宁（１０μｇ／ｋｇ）,对照组腹腔内注射等体积等渗盐水。于用药前、后每隔５ｍｉｎ,刺激坐骨神经,于股二头肌记录ＣＭＡＰ,研究肌松药作用下ＣＭＡＰ潜伏期、波幅的变化规律。结果 对照组：各时间组ＣＭＡＰ的潜伏期、波幅间均无明显改变（Ｐ〉０．０５）。实验组：ＣＭＡＰ变化可分为３个阶段：（１）诱导     

108例腰椎间盘突出症患者行肌电图检查结果分析

目的运用肌电图检查腰椎间盘突出症患者,观察脊神经根损害的电生理表现。方法筛选我院2011年3月-5月住院行手法治疗腰椎间盘突出症患者108例,均行针极肌电图（EMG）检查,观察相应节段椎旁肌静息状态下自发电位,相应神经根所支配的双下肢肌肉静息状态、轻收缩和大力收缩时的肌电图表象。结果对椎旁肌针极肌电图检测和下肢肌肉检测相比,椎旁肌检测的阳性率明显高于远端肢体。结论椎旁肌电生理检查对腰椎间盘突出症患者敏感性高,对神经根损害提供了电生理信息,对腰椎间盘突出症诊断是具有重要意义的。     

清醒状态下兔Oddi括约肌肌电活动检测模型的建立

目的：建立清醒状态兔Oddi括约肌（SO）肌电检测的动物模型,研究其肌电活动特征。方法：将成年家兔麻醉后,于胆囊底部置管一根;将十二指肠大乳头对系膜缘与间置的空肠袢远端吻合,空肠袢关闭后与胆囊内置管分别埋置于皮下,恢复14d后用环状电极进行清醒状态下SO肌电检测。对其消化间期、进食后、外源性胆囊收缩素（CCK）泵注下SO肌电幅值、频率及每分钟运动指数进行分析。结果：利用该模型可以在清醒状态下稳定记录到SO肌电活动,表现为慢波恒定基础上快波的周期性变化,进食后SO的快波增强,外源性CCK对兔SO的肌电有兴奋作用。结论：清醒状态下SO肌电活动检测更能反映括约肌的功能状态,这为今后研究病理状态下SO的活动提供了技术平台。     

Rowers with a recent history of low back pain engage different regions of the lumbar erector spinae during rowing

ObjectivesDespite the high prevalence of low back pain (LBP) in rowers, there are few studies investigating changes in lumbar muscle activation in rowers with a recent history of LBP. Such knowledge is relevant to understand potential mechanisms contributing to the maintenance and recurrence of LBP in rowers. For the first time, we evaluate the spatial distribution of erector spinae (ES) activity in rowers with and without a recent history of LBP, using a novel application of high-density surface electromyography (HDEMG).DesignCross-sectional study.MethodsAsymptomatic rowers (N = 10) and rowers with a recent history of LBP (N = 8) performed 7 × 4-min exercise bouts (rowing ergometer) until volitional exhaustion. HDEMG signals were acquired bilaterally over the lumbar ES and the root mean square (RMS) amplitude and entropy were analyzed. In addition, the y-axis coordinate of the barycentre (RMS-map) was used to assess changes in ES spatial activation.ResultsAs the load increased, rowers with LBP showed higher amplitude (p < 0.01) and less complexity (entropy) of the HDEMG signals (p < 0.001). In addition, rowers with LBP showed opposite displacements of the barycentre, specifically showing a caudal shift of muscle activity at high intensities (p < 0.001).ConclusionsBoth the magnitude of activation and distribution of ES activity were altered in rowers with a recent history of LBP. The lower complexity of signals together with the caudal displacements of the barycentre suggest an inefficient recruitment of the ES as the load progressed. Modification of the rowing technique in conjunction with feedback from HDEMG might prove useful in future studies.     

Relative efficacy of clinical examination,electromyography, plain film radiography,myelography and lumbar phlebography in the diagnosis of low back pain and sciatica

Summary The procedures used in the investigation of low back pain and sciatica have been subjected to a double statistical analysis to determine their diagnostic accuracy, since contradictory opinions have been experessed in the literature. It was found that only lumbar phlebography was more accurate than the most simple procedure, the clinical examination. Myelography is more accurate than clinical examination only in making a positive diagnosis. In this case, it equals the reliability of lumbar phlebography, but so does plain film radiography which however leads to a positive diagnosis less constantly. Lumbar phlebography is the most accurate procedure for making a nagative diagnosis, mainly by avoiding a false negative conclusion. A comparison is made with the statements in the literature and the complementary use of the different procedures is proposed for the investigation of low back pain and sciatica.     

Flexed lumbar spine postures are associated with greater strength and efficiency than lordotic postures during a maximal lift in pain-free individuals

BackgroundInspite of common lifting advice to maintain a lordotic posture, there is debate regarding optimal lumbar spine posture during lifting. To date, the influence of lumbar posture on trunk muscle recruitment, strength and efficiency during high intensity lifting has not been fully explored.Research questionHow do differences in lumbar posture influence trunk extensor strength (moment), trunk muscle activity, and neuromuscular efficiency during maximal lifting?MethodsTwenty-six healthy participants adopted three lumbar postures (maximal extension (lordotic), mid-range (flat-back), and fully flexed) in a free lifting position. Motion analysis and force measurements were used to determine the back extensor, hip and knee moments. Surface electromyography (EMG) of three trunk extensors and the internal obliques were recorded. Neuromuscular efficiency (NME) was expressed as a ratio of normalised extensor moment to normalised EMG.ResultsSignificantly higher back extensor moments were exerted when moving from an extended to mid-range, and from a mid-range to fully flexed lumbar posture. This was accompanied by a decrease in activity across all three back extensor muscles (P < 0.001) resulting in a higher NME of these muscles in more flexed postures. Change in lumbar posture did not influence hip or knee moments or internal oblique activation.SignificanceA flexed-back posture is associated with increased strength and efficiency of the back muscles compared to a lordotic posture. These findings further question the manual handling advice to lift with a lordotic lumbar spine.     

Gluteus medius muscle activity during gait in people with and without chronic nonspecific low back pain: A case control study

BackgroundResearch investigating differences in gluteus medius muscle activity in those with and without chronic nonspecific low back pain is both limited and conflicting. Additionally, in these populations the relationship between gluteus medius muscle activity, foot type, and transversus abdominis muscle thickness is unclear.Research questionWe aimed to investigate gluteus medius muscle activity during gait in those with and without chronic nonspecific low back pain. Secondarily, we aimed to explore the association between gluteus medius muscle activity, foot type, and transversus abdominis muscle thickness within groups.MethodsThis case control study recruited 30 people with and 30 people without chronic nonspecific low back pain and matched participants by age (±5 years), sex, and body mass index (±2 BMI units). Gluteus medius muscle activity was measured with surface electromyography during walking gait, with foot type and transversus abdominis muscle thickness measured with the Foot Posture Index and ultrasound respectively. The Mann-Whitney U test was used to investigate differences in gluteus medius muscle activity between groups. Spearman rank order correlation was performed to explore the association between gluteus medius muscle activity, foot type, and transversus abdominis thickness within each group. A linear regression was used to analyse significant correlations (P < 0.05).ResultsWe found no significant differences in gluteus medius muscle activity between groups. However, there was a moderate correlation between the Foot Posture Index score and gluteus medius peak amplitude (P = 0.04) for those with mild to moderate chronic nonspecific low back pain.SignificanceClinicians should be aware that patients with mild to moderate chronic nonspecific low back pain may not demonstrate significant differences in gluteus medius muscle activity compared to those without back pain. Additionally, higher peak gluteus medius muscle activity is likely to occur in people with mild to moderate chronic nonspecific low back pain and planus feet.     

歼击机飞行员住院疾病谱分析

目的 研究歼击机飞行员住院疾病谱的变化规律. 方法 对医院所收治的1200名歼5、歼6和歼7飞行员的疾病谱进行对比分析. 结果 ①排前10位的病症为空中晕厥、腰椎病、慢性胃炎、加速度耐力不良、地面晕厥、航空性中耳炎、泌尿系结石、眩晕、神经衰弱和颈椎病.②排在歼7飞行员前10位的病症为腰椎病、脂肪肝、慢性胃炎、噪声性聋、高脂血症、右束支传导阻滞、高血压、严重飞行错觉、航空性中耳炎和肝内胆管结石. 结论 歼5、6、7三型歼击机飞行员住院疾病谱有所不同,与歼5、6相比歼7飞行员有些病症呈下降趋势,有些病症呈上升趋势,对其原因进行分析有助于提高航卫保障质量.     

中频电针疗法对第三腰椎横突综合征的疗效观察

目的：观察中频电针疗法对第三腰椎横突综合征的疗效。方法：选取90例腰三横突综合征患者,随机分为中频电针组、针刀封闭组及传统电针组,于疗程后1周对3组患者临床疗效及腰痛程度进行评定。结果：中频电针组、针刀封闭组两组疗效、疗后VAS评分及ODI指数均优于传统电针组（P〈0.05）,但两组之间疗效接近,VAS评分及ODI指数差异无统计学意义（P〉0.05）。结论：采用中频电针疗法治疗第三腰椎横突综合征接近针刀封闭治疗疗效,操作简单,值得临床推广应用。     

Ankle reaction times with tray usage following a slip perturbation between subjects with and without chronic low back pain

BackgroundAbnormal stepping strategies have been associated with handheld tasks in subjects with chronic low back pain (LBP). However, the dominant ankle reactions of subjects with LBP remain unclear following a perturbation during handheld tasks.Research questionAre there differences in the reaction times of the ankle muscles during handheld tasks between subjects with and without LBP following a treadmill-induced slip perturbation?MethodsThirty-seven right limb dominant subjects with LBP and 37 subjects without LBP participated in the study. Each subject was introduced to a slip perturbation (1.37 m/sec velocity for 8.22 cm) with and without a handheld tray in random order. Subjects were allowed to recover by stepping forward for a 0.12 s duration while bilateral tibialis anterior (TA) and gastrocnemius (GA) muscle reaction times were measured by electromyography (EMG).ResultsThe EMG results indicated that the groups demonstrated significant interactions on the limb sides and muscles (F = 4.86, p = 0.03). The dominant TA reaction time was significantly faster in the LBP group (t = 2.14, p = 0.03) while holding a tray.SignificanceThe LBP group demonstrated faster reaction times on the dominant TA muscles during perturbations. Clinicians need to consider dominance-dependent compensatory ankle dorsiflexion strategies in LBP patients to help enhance dynamic balance and control.     

腰椎关节突关节基础研究新进展

腰椎关节突关节是脊柱连接的重要关节。临床上往往仅注重椎间盘突出症,而忽略腰椎关节突关节炎引起的症状。近年来,随着医学影像学的飞速发展,人们越来越重视对腰椎关节突关节的研究,在解剖学、生物力学以及病因学上都取得了一些新的进展。     

下腰痛患者腰背浅筋膜水肿的MRI诊断

目的探讨下腰痛患者腰背浅筋膜水肿的MRI诊断。方法133例下腰痛患者（其中22例临床诊断腰背肌筋膜炎）均采用GE Signa0．2 TMRI进行腰椎常规SE序列、FSE序列检查,层厚5mm。结果133例下腰痛患者MRI显示腰椎棘突后方浅筋膜中线区域异常长T1、长T2信号36例,其中合并腰椎间盘病变、腰椎骨质增生等退行性病变30例,腰椎椎体血管瘤1例。临床诊断腰背肌筋膜炎22例中MRI显示浅筋膜异常长T1、长T2信号16例,其中合并腰椎间盘病变、腰椎骨质增生等退行性病变14例。结论下腰痛患者腰背浅筋膜水肿发生率较高,MRI显示敏感,诊断准确,因此,NRI对指导治疗具有很高的临床价值。     

椎间盘源性下腰痛的MRI和椎间盘造影的相关性研究

目的 探讨椎间盘源性下腰痛患者的MRI和椎间盘造影表现与椎间盘造影一致性诱发痛的相关性.方法 93例慢性下腰痛患者腰椎MR检查和256个腰椎椎间盘造影.椎间盘造影按照Adams等分级标准进行,MRI髓核退变按Pearce等分级标准,终板退变按Medic标准分级,疼痛诱发评价分为一致性诱发痛和无痛或非一致性诱发痛.分析MRI椎间盘退变分级、椎间盘造影分级与一致性诱发痛的相关性.获得的数据采用X2检验进行统计分析.结果 93例256个椎间盘造影,116个出现一致性诱发痛.椎间盘造影:Ⅰ型椎间盘17个(6.6%),Ⅱ型椎间盘25个(9.8%),Ⅲ型椎间盘91个(35.5%),Ⅳ型椎间盘77个(30.1%),Ⅴ型椎间盘46个(18.0%).MRI椎间盘退变分级:Ⅰ级23个(9.0%),Ⅱ级34个(13.3%),Ⅲ级84个(32.8%),Ⅳ级85个(33.2%),Ⅴ级30个(11.7%).椎间盘造影与MRl分级密切相关(r=0.62,X2=160.87,P<0.01);椎间盘造影Ⅳ-Ⅴ型椎间盘123个,104个出现一致性诱发痛,与一致性诱发痛密切相关(r=0.60,X2=144.08,P<0.01);MRI椎间盘Ⅳ-Ⅴ级退变115个,99个出现一致性诱发痛,与一致性诱发痛密切相关(r=0.59,X2=137.11,P<0.01);椎间盘后缘高信号区60个,52个出现一致性诱发痛,两者具有密切相关性(r=0.41,X2=51.93,P<0.01);椎间盘终板异常58个,51个出现一致性诱发痛,两者具有密切相关性(r=0.41,X2=52.76,P<0.01).结论 MRI显示髓核中、重度退变、椎间盘后缘高信号区、椎体终板退变,以及椎间盘造影表现为外纤维环破裂、后纵韧带复合体破裂和出现一致性诱发痛时,可高度提示椎间盘源性下腰痛.椎间盘造影显示的椎间盘纤维环破裂伴随造影时的一致性诱发痛,是椎间盘源性下腰痛诊断的重要依据.