摘要
目的分析男性青少年特发性脊柱侧弯(adolescent idiopathic scoliosis,AIS)患者背部肌群的动态量化肌肉激活异常与脊柱畸形之间的关系,构建基于表面肌电(surface electromyography,sEMG)参数的性别特异性评估模型,为优化男性AIS的早期筛查、精准干预及康复策略提供生物力学依据。方法纳入60名男性青少年(AIS组30例,对照组30例),采用无线肌电系统采集静态(直立、前屈30°)与动态(冠状面侧屈)任务中竖脊肌、多裂肌及背阔肌EMG信号。通过均方根(root mean square,RMS)、积分肌电(integrated electromyography,iEMG)、对称性指数(symmetry index,SI)、激活时序差(ΔT)及协同收缩率(co-contraction rate,CR)等指标分析肌肉活动模式,并基于sEMG指标参数构建AIS预测模型。结果在静态任务中,AIS组凸侧竖脊肌与多裂肌RMS均显著高于对照组(P<0.01),而凹侧ES与MF激活强度分别降低18.7%(P=0.021)和23.9%(P=0.002)。前屈30°时,凸侧竖脊肌RMS较对照组显著升高(P<0.01),SI较对照组下降(P<0.001),凸侧激活较对照组延迟。动态侧屈中,AIS组向凹侧屈曲时凸侧竖脊肌iEMG显著升高(P=0.017),且激活时序紊乱(P<0.001)。多裂肌呈现相似趋势,凹侧屈曲iEMG显著升高(P=0.002),而背阔肌iEMG无显著差异。多元回归分析表明,SI、凸侧竖脊肌RMS及ΔT联合可解释82%的Cobb角变异(调整R^(2)=0.82),其中SI每降低10%,Cobb角增加6.5°(P<0.001)。结论男性AIS患者背部肌群呈现凸侧过度激活与凹侧抑制的特征性sEMG异常,动态任务中时序紊乱及协同收缩增强进一步反映神经控制缺陷。
Objective The association between dynamically quantified abnormal muscle activation and spinal deformities in males with adolescent idiopathic scoliosis(AIS)was analyzed,and a gender-specific assessment model based on surface electromyography(sEMG)parameters was constructed,aiming to provide a biomechanical basis for optimizing early screening,precise intervention,and rehabilitation strategies for male AIS patients.Methods Sixty male adolescents were enrolled(AIS group:30 cases;control group:30 cases).A wireless sEMG system was utilized to collect signals from the erector spinae(ES),multifidus(MF),and latissimus dorsi(LD)in static(upright standing,30°forward bending)and dynamic(coronal plane lateral flexion)tasks.Muscle activation patterns were analyzed using root mean square(RMS),integrated electromyography(iEMG),symmetry index(SI),activation time difference(ΔT),and co-contraction rate(CR).An AIS prediction model was constructed based on sEMG parameters.Results In static tasks,the RMS values of convex ES and MF in the AIS group were significantly higher than those in the control group(P<0.01).The activation intensity of concave ES and MF decreased by 18.7%(P=0.021)and 23.9%(P=0.002),respectively.During 30°forward bending,the RMS of convex-side ES significantly increased compared to the control group(P<0.01),SI decreased significantly(P<0.001),and convex-side activation was delayed.During dynamic lateral flexion,the iEMG of convex ES during concave-side flexion significantly increased(P=0.017),accompanied by activation timing disorder(P<0.001).MF showed a similar trend,with significantly higher iEMG during concave-side flexion(P=0.002),while the iEMG of LD exhibited no significant differences.Multivariate regression analysis revealed that SI,convex ES RMS,andΔT collectively explained 82%of Cobb angle variability(adjusted R^(2)=0.82),with a 10%decrease in SI predicting a 6.5°increase in Cobb angle(P<0.001).Conclusions Male AIS patients exhibit characteristic sEMG abnormalities,including convex-side hyperactivation and concave-side inhibition of dorsal muscle groups.Temporal disorder and enhanced co-contraction in dynamic tasks further reflect neuromotor control deficits.
作者
吴旭东
刘子青
马佩
王乐军
WU Xudong;LIU Ziqing;MA Pei;WANG Lejun(Advanced Vocational Technical College,Shanghai University of Engineering Science,Shanghai 200437,China;Department of Rehabilitation,Yangpu District Traditional Chinese Medicine Hospital,Shanghai 200090,China;Sport and Health Research Center,Department of Physical Education,Tongji University,Shanghai 200092,China)
出处
《医用生物力学》
北大核心
2026年第1期159-166,共8页
Journal of Medical Biomechanics
基金
上海市教育科学研究项目(C2023222)
国家自然科学基金项目(12272272)。
关键词
青少年特发性脊柱侧弯
表面肌电
肌肉对称性
脊柱畸形
康复评估
adolescent idiopathic scoliosis
surface electromyography
muscle symmetry
spinal deformity
rehabilitation assessment
