This research presents a Human Lower Limb Activity Recognition(HLLAR)system that identifies specific activities and predicts the angles of the knees simultaneously,based on the EMG signals.The HLLAR systems streamline...This research presents a Human Lower Limb Activity Recognition(HLLAR)system that identifies specific activities and predicts the angles of the knees simultaneously,based on the EMG signals.The HLLAR systems streamlines the research on the lower limb activities.The HILLAR model includes Discrete Hermite Wavelets Transform-based Synchrosqueezing(DHWTS),Deep Two-Layer Multiscale Convolutional Neural Network(DTLMCNN),and Generalized Regression Neural Network(GRNN)as feature extraction,activity recognition,and knee angle prediction respectively.Electromyography signal-based automatic lower limb activity detection is crucial to rehabilitation and human movement analysis.Yet several of these methods face issues in feature extraction in complex data,overlapping signals,extraction of crucial parameters,and adaptation constraints.This research aims classify lower limb activities and predict knee joint angles from electromy-ography signals using HILLAR model.The model is validated on two datasets,comprising 26 subjects performing three classes of activities:walking,standing,and sitting.The proposed model obtained a classification accuracy of 99.95%,along with significant achievements in precision(99.93%),recall(99.91%),and F1-score(99.93%).The generalized regression neural network predicted angles of the knee joint with a root mean squared error of 1.25%.Robustness is demonstrated through consistent results in five-fold cross-validation and statistical significance testing(p-value=0.004,McNemar's test).Additionally,the proposed model showed superior performance over baseline methods by reducing error rates by 18%and decreasing processing time to 0.98 s.展开更多
Objective:To observe the effects of acupuncture-moxibustion combined with rehabilitation training on limb function and surface electromyography(sEMG)in patients with hemiplegia after stroke(HAS).Methods:Eighty-four HA...Objective:To observe the effects of acupuncture-moxibustion combined with rehabilitation training on limb function and surface electromyography(sEMG)in patients with hemiplegia after stroke(HAS).Methods:Eighty-four HAS patients were divided into a control group and a combined group using the random number table method,with 42 cases in each group.The control group received dynamic-static balance rehabilitation training,and the combined group additionally received Fu Zheng Bu Tu(strengthening the healthy Qi and invigorating the spleen)acupuncture-moxibustion therapy.After 4 weeks of treatment,their clinical efficacy was compared,and they were also observed for changes in limb motor function,muscle spasticity level,balance ability,sEMG indices,and hemorheological parameters,as well as adverse reactions.Results:After treatment,the combined group had a higher total effective rate than the control group(P<0.05).After the intervention,both groups presented significant increases in the upper-and lower-limb Fugl-Meyer assessment(FMA)score,Berg balance scale(BBS)score,maximum voluntary contraction(MVC),root mean square(RMS),and integrated electromyography(iEMG);the combined group had superior improvements compared to the control group(P<0.05).After treatment,the modified Ashworth scale(MAS)scores of the elbow,wrist,knee,and ankle joints,and the levels of plasma viscosity(PV),whole blood viscosity(WBV),and hematocrit(HCT)dropped in both groups and were lower in the combined group than in the control group(P<0.05).Neither group showed significant adverse reactions during the treatment period.Conclusion:Fu Zheng Bu Tu acupuncture-moxibustion plus dynamic-static balance rehabilitation training can effectively alleviate muscle spasticity,improve balance ability,enhance sEMG signal levels,modulate hemodynamics,and promote the recovery of limb motor function in HAS patients.展开更多
Dysphagia is a common complication of ischemic stroke and is usually difficult to treat.The mainstay of standard therapy of post-stroke dysphagia(PSD)is effortful swallowing.Since its introduction in 2004,there is inc...Dysphagia is a common complication of ischemic stroke and is usually difficult to treat.The mainstay of standard therapy of post-stroke dysphagia(PSD)is effortful swallowing.Since its introduction in 2004,there is increasing evidence that sur-face electromyography-guided biofeedback training(EMGBT)can enhance the therapeutic effect of standard LE.In this editorial,we comment on the article by Meng et al published in the recent issue of the World Journal of Clinical Cases,which provided evidence that particularly extensive EMGBT with an increased number of sessions is definitively more effective than the standard speech therapy or or-dinary EMGBT.Among the 90 PSD patients with ischemic stroke or intracerebral bleeding,those who underwent EMGBT in more sessions than usual particularly benefited from the approach.It was concluded that EMGBT is more effective than traditional swallowing training in improving dysphagia and swallowing disor-ders as well as hyoid-laryngeal complex movement speed in PSD patients.展开更多
Purpose:To explore the clinical value of Electromyography(EMG)and Heart Rate Variability(HRV)in the diagnosis of early DPN and provide the basis for early diagnosis,treatment,and prevention of DPN.Methods:105 patients...Purpose:To explore the clinical value of Electromyography(EMG)and Heart Rate Variability(HRV)in the diagnosis of early DPN and provide the basis for early diagnosis,treatment,and prevention of DPN.Methods:105 patients with type 2 diabetes mellitus(T2DM)in the Changji People’s Hospital were treated from January 2023 to December 2023.They were stratifi ed into DPN-symptomatic(DPN group,n=55)and DPN-asymptomatic(NDPN group,n=50)cohorts based on the presence or absence of clinically confi rmed diabetic peripheral neuropathy.The clinical biochemical indicators,nerve electromyography,and HRV parameters were obtained from electronic medical records,and diff erences in detection results were compared between the two groups.Logistic regression was applied to analyze the infl uencing factors of DPN in diabetes patients.The receiver operating characteristic(ROC)curve was applied to analyze the diagnostic value of EMG combined with other parameters for DPN.Results:From the results of the general information,diabetes duration,glycosylated hemoglobin(HbA1c),low-density lipoprotein cholesterol(LDL-C),total cholesterol(TC)and FBG in the DPN group were significantly differences compared with the NDPN group(p<0.05).There were no statistically significant differences in gender,age years,uric acid,and other general data(p>0.05).Compared with the NDPN group,the motor nerve conduction velocity(MNCV),sensory nerve conduction velocity(SNCV)of the ulnar nerve,median nerve,and tibial nerve in the DPN group were statistically signifi cant(p>0.05).The DPN group had higher average F wave latency and H wave latency in the tested nerve,with statistical signifi cance(p<0.05).HRV parameters decreased signifi cantly(SDNN,rMSSD,PNN50,and SDANN,all p<0.05).ROC analysis showed that the area under the ROC curve(AUC)of the combined diagnosis of DPN by duration of diabetes,HbA1c,EMG,and HRV was 0.897,the accuracy was 82.86%,the sensitivity was 78.00%,and the specifi city was 87.27%.The AUC of the combined diagnosis of the four parameters for DPN was signifi cantly higher than that of each alone(p<0.05).Conclusion:The combination of EMG and HRV has a high value in the assessment of DPN and can be used for early assessment of the extent of the lesion.展开更多
Stroke survivors often face significant challenges when performing daily self-care activities due to upper limb motor impairments.Traditional surface electromyography(sEMG)analysis typically focuses on isolated hand p...Stroke survivors often face significant challenges when performing daily self-care activities due to upper limb motor impairments.Traditional surface electromyography(sEMG)analysis typically focuses on isolated hand postures,overlooking the complexity of object-interactive behaviors that are crucial for promoting patient independence.This study introduces a novel framework that combines high-density sEMG(HD-sEMG)signals with an improved Whale Optimization Algorithm(IWOA)-optimized Long Short-Term Memory(LSTM)network to address this limitation.The key contributions of this work include:(1)the creation of a specialized HD-sEMG dataset that captures nine continuous self-care behaviors,along with time and posture markers,to better reflect real-world patient interactions;(2)the development of a multi-channel feature fusion module based on Pascal’s theorem,which enables efficient signal segmentation and spatial–temporal feature extraction;and(3)the enhancement of the IWOA algorithm,which integrates optimal point set initialization,a diversity-driven pooling mechanism,and cosine-based differential evolution to optimize LSTM hyperparameters,thereby improving convergence and global search capabilities.Experimental results demonstrate superior performance,achieving 99.58%accuracy in self-care behavior recognition and 86.19%accuracy for 17 continuous gestures on the Ninapro db2 benchmark.The framework operates with low latency,meeting the real-time requirements for assistive devices.By enabling precise,context-aware recognition of daily activities,this work advances personalized rehabilitation technologies,empowering stroke patients to regain autonomy in self-care tasks.The proposed methodology offers a robust,scalable solution for clinical applications,bridging the gap between laboratory-based gesture recognition and practical,patient-centered care.展开更多
目的观察电针联合悬吊训练(sling exercise therapy,SET)治疗慢性非特异性下腰痛(chronic nonspecific low back pain,CNLBP)的临床疗效。方法将72例CNLBP患者随机分为观察组和对照组,每组36例。对照组行SET治疗,观察组在对照组基础上...目的观察电针联合悬吊训练(sling exercise therapy,SET)治疗慢性非特异性下腰痛(chronic nonspecific low back pain,CNLBP)的临床疗效。方法将72例CNLBP患者随机分为观察组和对照组,每组36例。对照组行SET治疗,观察组在对照组基础上采用电针腰夹脊穴治疗。观察两组治疗前后视觉模拟评分法(visual analog scale,VAS)、腰椎功能障碍指数(oswestry disability index,ODI)、日本骨科协会(Japanese Orthopaedc Association,JOA)评分的变化,并比较两组治疗前后竖脊肌、多裂肌表面肌电图(surface electromyography,sEMG)中的指标均方根值(root mean square,RMS)和中位频率值(median frequency value,MF)。结果两组治疗2周后VAS、ODI评分低于治疗前,治疗后VAS、ODI评分低于治疗2周后和治疗前,差异有统计学意义(P<0.05);观察组治疗2周后和治疗后VAS、ODI评分低于对照组,差异有统计学意义(P<0.05)。两组治疗2周后JOA评分高于治疗前,治疗后JOA评分高于治疗2周后和治疗前,差异有统计学意义(P<0.05);观察组治疗2周后和治疗后JOA评分高于对照组,差异有统计学意义(P<0.05)。对照组竖脊肌、多裂肌双侧RMS值治疗2周后与治疗前比较,差异无统计学意义(P>0.05);治疗后竖脊肌、多裂肌双侧RMS值高于治疗2周后和治疗前,差异有统计学意义(P<0.05);观察组治疗2周后竖脊肌、多裂肌双侧RMS值高于治疗前,治疗后竖脊肌、多裂肌双侧RMS值高于治疗2周后和治疗前,差异有统计学意义(P<0.05);观察组治疗2周后、治疗后竖脊肌和多裂肌双侧RMS值高于对照组,差异有统计学意义(P<0.05)。两组治疗2周后竖脊肌、多裂肌双侧MF值高于治疗前,治疗后竖脊肌、多裂肌双侧MF值高于治疗2周后和治疗前,差异有统计学意义(P<0.05);观察组治疗2周后和治疗后竖脊肌、多裂肌双侧MF值高于对照组,差异有统计学意义(P<0.05)。结论电针联合SET训练能更好地减轻患者疼痛,改善椎旁核心肌(多裂肌、竖脊肌)的肌电信号,促进腰椎核心肌群功能恢复。展开更多
Objective To observe the influence of different acupoint combinations on immediate effect of surface electromyography of patients with cervical spondylosis, and to explore the interactions and laws among different acu...Objective To observe the influence of different acupoint combinations on immediate effect of surface electromyography of patients with cervical spondylosis, and to explore the interactions and laws among different acupoint combinations. Methods Acupuncture in three kinds of different acupoint combinations was conducted on 90 patients with cervical spondylosis（three groups）： group A [distal point selection group： Kūnlún（昆仑 BL 60） and Hòuxī（后溪 SI 3）]; group B [local point selection group： Fēngchí（风池 GB 20） and Tiānzhù（天柱 BL 10）]; group C（distal and local point selection group： BL 60, SI 3, GB 20 and BL 10）. Self control before and after treatment was adopted to observe the mean value of surface electromyography（SEMG） amplitude, to measure the mean values of integrated electromyography（IEMG） and electromyography root mean square（RMS）, and to calculate the variation rate of electromyography amplitude of trapezius on the affected side of patients before and after acupuncture. The differences of influences of different acupoint combinations on immediate effect of surface electromyography were compared intra-group, and the differences among the three groups after acupuncture were also compared. Results According to the intragroup comparison before and after acupuncture, the differences of mean value of electromyography amplitude, variation rate of electromyography amplitude, IEMG and RMS were both statistically significant（all P〈0.05）. According to the inter-group comparison after acupuncture, the mean value of electromyography amplitude, variation rate of electromyography amplitude, IEMG and RMS varied in different degrees, however, the differences were not significant（all P〉0.05）; there was no significant difference in the total effective rate among the three groups（P〉0.05）. Conclusion Acupuncture treatment in different acupoint combinations can increase IEMG and RMS and reduce mean value of electromyography amplitude and variation rate of electromyography amplitude, enhance cervical vertebral stability and active contractility of muscle fiber, and improve the fatigue resistance of neck flexion; while, the therapeutic effect of acupuncture on cervical spondylosis has nothing to do with the distance or the number of selected acupoint.展开更多
目的:探讨仰卧凌空直蹬腿锻炼对经椎间孔入路内镜下腰椎间盘切除术(transforaminal endoscopic lumbar discectomy,TELD)后患者肌群调控与筋骨平衡作用机制。方法:选取了2024年7月至2025年1月行TELD患者38例,根据TELD后锻炼方式不同分...目的:探讨仰卧凌空直蹬腿锻炼对经椎间孔入路内镜下腰椎间盘切除术(transforaminal endoscopic lumbar discectomy,TELD)后患者肌群调控与筋骨平衡作用机制。方法:选取了2024年7月至2025年1月行TELD患者38例,根据TELD后锻炼方式不同分为功法组和飞燕组,各19例。两组患者于术后2周拆线后行4周的术后康复锻炼。功法组19例,男12例,女7例;左侧9例,右侧10例;年龄25~61(40.37±10.40)岁;手术节段在L_(4,5)的10例,L_(5)S_(1)的9例;身体质量指数(body mass index,BMI)为19.72~27.68(23.48±2.46)kg·m^(-2);采用仰卧凌空直蹬腿锻炼。飞燕组19例,男16例,女3例;左侧9例,右侧10例;年龄25~67(40.16±10.86)岁;手术节段在L_(4,5)的11例,在L_(5)S_(1)的8例;BMI为18.43~29.28(24.49±2.88)kg·m^(-2);采用“飞燕”式锻炼。比较两组锻炼前及锻炼4周后的疼痛视觉模拟评分(visual analogue scale,VAS)、腰椎功能障碍指数(Oswestry disability index,ODI),比较两组锻炼前后患侧的竖脊肌、腹直肌、股内侧肌、股外侧肌、腓肠肌的最大收缩值(maximal voluntary contraction,MVC)、肌电均方根值(root mean square,RMS)、积分肌电值(integral of the EMG signal,INT)、平均功率频率(mean power frequency,MPF)、RMS占最大自主收缩的百分比(RMS/MVC值,%MVC),比较两组锻炼前后患侧的竖脊肌、腹直肌、股内侧肌、股外侧肌、腓肠肌的肌肉肌张力F值(oscillation frequency),硬度S值(dynamic stiffness)和弹性D值(logarithmic decrement of a muscle's natural oscillation)。结果:功法组锻炼后VAS低于锻炼前,两组锻炼后ODI均低于锻炼前,差异有统计学意义(P<0.05);飞燕组锻炼后VAS与锻炼前比较,差异无统计学意义(P>0.05);功法组锻炼后VAS、ODI低于飞燕组,差异有统计学意义(P<0.05);功法组竖脊肌锻炼后RMS、INT、MPF、%MVC低于飞燕组,差异有统计学意义(P<0.05);功法组腹直肌锻炼后MVC、RMS、INT、%MVC高于飞燕组,MPF低于飞燕组,差异均有统计学意义(P<0.05);飞燕组竖脊肌锻炼后F、S值高于锻炼前,功法组腹直肌、股内侧肌、股外侧肌锻炼后D值均低于锻炼前,差异均有统计学意义(P<0.05)。结论:仰卧凌空直蹬腿运动可有效缓解术后疼痛,促进腰椎功能恢复,激活核心肌群,增强下肢肌群协同作用,改善肌肉张力、硬度和弹性,可为腰椎内镜术后康复锻炼提供新方案。展开更多
文摘This research presents a Human Lower Limb Activity Recognition(HLLAR)system that identifies specific activities and predicts the angles of the knees simultaneously,based on the EMG signals.The HLLAR systems streamlines the research on the lower limb activities.The HILLAR model includes Discrete Hermite Wavelets Transform-based Synchrosqueezing(DHWTS),Deep Two-Layer Multiscale Convolutional Neural Network(DTLMCNN),and Generalized Regression Neural Network(GRNN)as feature extraction,activity recognition,and knee angle prediction respectively.Electromyography signal-based automatic lower limb activity detection is crucial to rehabilitation and human movement analysis.Yet several of these methods face issues in feature extraction in complex data,overlapping signals,extraction of crucial parameters,and adaptation constraints.This research aims classify lower limb activities and predict knee joint angles from electromy-ography signals using HILLAR model.The model is validated on two datasets,comprising 26 subjects performing three classes of activities:walking,standing,and sitting.The proposed model obtained a classification accuracy of 99.95%,along with significant achievements in precision(99.93%),recall(99.91%),and F1-score(99.93%).The generalized regression neural network predicted angles of the knee joint with a root mean squared error of 1.25%.Robustness is demonstrated through consistent results in five-fold cross-validation and statistical significance testing(p-value=0.004,McNemar's test).Additionally,the proposed model showed superior performance over baseline methods by reducing error rates by 18%and decreasing processing time to 0.98 s.
基金supported by the Health and Medical Science Research Project of Shaanxi Province(陕西省卫生健康科研项目,No.2021H0217).
文摘Objective:To observe the effects of acupuncture-moxibustion combined with rehabilitation training on limb function and surface electromyography(sEMG)in patients with hemiplegia after stroke(HAS).Methods:Eighty-four HAS patients were divided into a control group and a combined group using the random number table method,with 42 cases in each group.The control group received dynamic-static balance rehabilitation training,and the combined group additionally received Fu Zheng Bu Tu(strengthening the healthy Qi and invigorating the spleen)acupuncture-moxibustion therapy.After 4 weeks of treatment,their clinical efficacy was compared,and they were also observed for changes in limb motor function,muscle spasticity level,balance ability,sEMG indices,and hemorheological parameters,as well as adverse reactions.Results:After treatment,the combined group had a higher total effective rate than the control group(P<0.05).After the intervention,both groups presented significant increases in the upper-and lower-limb Fugl-Meyer assessment(FMA)score,Berg balance scale(BBS)score,maximum voluntary contraction(MVC),root mean square(RMS),and integrated electromyography(iEMG);the combined group had superior improvements compared to the control group(P<0.05).After treatment,the modified Ashworth scale(MAS)scores of the elbow,wrist,knee,and ankle joints,and the levels of plasma viscosity(PV),whole blood viscosity(WBV),and hematocrit(HCT)dropped in both groups and were lower in the combined group than in the control group(P<0.05).Neither group showed significant adverse reactions during the treatment period.Conclusion:Fu Zheng Bu Tu acupuncture-moxibustion plus dynamic-static balance rehabilitation training can effectively alleviate muscle spasticity,improve balance ability,enhance sEMG signal levels,modulate hemodynamics,and promote the recovery of limb motor function in HAS patients.
文摘Dysphagia is a common complication of ischemic stroke and is usually difficult to treat.The mainstay of standard therapy of post-stroke dysphagia(PSD)is effortful swallowing.Since its introduction in 2004,there is increasing evidence that sur-face electromyography-guided biofeedback training(EMGBT)can enhance the therapeutic effect of standard LE.In this editorial,we comment on the article by Meng et al published in the recent issue of the World Journal of Clinical Cases,which provided evidence that particularly extensive EMGBT with an increased number of sessions is definitively more effective than the standard speech therapy or or-dinary EMGBT.Among the 90 PSD patients with ischemic stroke or intracerebral bleeding,those who underwent EMGBT in more sessions than usual particularly benefited from the approach.It was concluded that EMGBT is more effective than traditional swallowing training in improving dysphagia and swallowing disor-ders as well as hyoid-laryngeal complex movement speed in PSD patients.
基金supported by the Key Program of the Changji Prefecture Science and Technology Program(2023S04-10,2023S06-03).
文摘Purpose:To explore the clinical value of Electromyography(EMG)and Heart Rate Variability(HRV)in the diagnosis of early DPN and provide the basis for early diagnosis,treatment,and prevention of DPN.Methods:105 patients with type 2 diabetes mellitus(T2DM)in the Changji People’s Hospital were treated from January 2023 to December 2023.They were stratifi ed into DPN-symptomatic(DPN group,n=55)and DPN-asymptomatic(NDPN group,n=50)cohorts based on the presence or absence of clinically confi rmed diabetic peripheral neuropathy.The clinical biochemical indicators,nerve electromyography,and HRV parameters were obtained from electronic medical records,and diff erences in detection results were compared between the two groups.Logistic regression was applied to analyze the infl uencing factors of DPN in diabetes patients.The receiver operating characteristic(ROC)curve was applied to analyze the diagnostic value of EMG combined with other parameters for DPN.Results:From the results of the general information,diabetes duration,glycosylated hemoglobin(HbA1c),low-density lipoprotein cholesterol(LDL-C),total cholesterol(TC)and FBG in the DPN group were significantly differences compared with the NDPN group(p<0.05).There were no statistically significant differences in gender,age years,uric acid,and other general data(p>0.05).Compared with the NDPN group,the motor nerve conduction velocity(MNCV),sensory nerve conduction velocity(SNCV)of the ulnar nerve,median nerve,and tibial nerve in the DPN group were statistically signifi cant(p>0.05).The DPN group had higher average F wave latency and H wave latency in the tested nerve,with statistical signifi cance(p<0.05).HRV parameters decreased signifi cantly(SDNN,rMSSD,PNN50,and SDANN,all p<0.05).ROC analysis showed that the area under the ROC curve(AUC)of the combined diagnosis of DPN by duration of diabetes,HbA1c,EMG,and HRV was 0.897,the accuracy was 82.86%,the sensitivity was 78.00%,and the specifi city was 87.27%.The AUC of the combined diagnosis of the four parameters for DPN was signifi cantly higher than that of each alone(p<0.05).Conclusion:The combination of EMG and HRV has a high value in the assessment of DPN and can be used for early assessment of the extent of the lesion.
基金supported by the National Natural Science Foundation of China(72061006)the research on the auxiliary diagnosis system of chronic injury of levator scapulae based on the concept of digital twin(Contract No:Qian Kehe Support[2023]General 117)Research on indoor intelligent assisted walking robot for the rehabilitation of walking ability of the elderly(Contract No:Qian kehe Support[2023]General 124).
文摘Stroke survivors often face significant challenges when performing daily self-care activities due to upper limb motor impairments.Traditional surface electromyography(sEMG)analysis typically focuses on isolated hand postures,overlooking the complexity of object-interactive behaviors that are crucial for promoting patient independence.This study introduces a novel framework that combines high-density sEMG(HD-sEMG)signals with an improved Whale Optimization Algorithm(IWOA)-optimized Long Short-Term Memory(LSTM)network to address this limitation.The key contributions of this work include:(1)the creation of a specialized HD-sEMG dataset that captures nine continuous self-care behaviors,along with time and posture markers,to better reflect real-world patient interactions;(2)the development of a multi-channel feature fusion module based on Pascal’s theorem,which enables efficient signal segmentation and spatial–temporal feature extraction;and(3)the enhancement of the IWOA algorithm,which integrates optimal point set initialization,a diversity-driven pooling mechanism,and cosine-based differential evolution to optimize LSTM hyperparameters,thereby improving convergence and global search capabilities.Experimental results demonstrate superior performance,achieving 99.58%accuracy in self-care behavior recognition and 86.19%accuracy for 17 continuous gestures on the Ninapro db2 benchmark.The framework operates with low latency,meeting the real-time requirements for assistive devices.By enabling precise,context-aware recognition of daily activities,this work advances personalized rehabilitation technologies,empowering stroke patients to regain autonomy in self-care tasks.The proposed methodology offers a robust,scalable solution for clinical applications,bridging the gap between laboratory-based gesture recognition and practical,patient-centered care.
文摘目的观察电针联合悬吊训练(sling exercise therapy,SET)治疗慢性非特异性下腰痛(chronic nonspecific low back pain,CNLBP)的临床疗效。方法将72例CNLBP患者随机分为观察组和对照组,每组36例。对照组行SET治疗,观察组在对照组基础上采用电针腰夹脊穴治疗。观察两组治疗前后视觉模拟评分法(visual analog scale,VAS)、腰椎功能障碍指数(oswestry disability index,ODI)、日本骨科协会(Japanese Orthopaedc Association,JOA)评分的变化,并比较两组治疗前后竖脊肌、多裂肌表面肌电图(surface electromyography,sEMG)中的指标均方根值(root mean square,RMS)和中位频率值(median frequency value,MF)。结果两组治疗2周后VAS、ODI评分低于治疗前,治疗后VAS、ODI评分低于治疗2周后和治疗前,差异有统计学意义(P<0.05);观察组治疗2周后和治疗后VAS、ODI评分低于对照组,差异有统计学意义(P<0.05)。两组治疗2周后JOA评分高于治疗前,治疗后JOA评分高于治疗2周后和治疗前,差异有统计学意义(P<0.05);观察组治疗2周后和治疗后JOA评分高于对照组,差异有统计学意义(P<0.05)。对照组竖脊肌、多裂肌双侧RMS值治疗2周后与治疗前比较,差异无统计学意义(P>0.05);治疗后竖脊肌、多裂肌双侧RMS值高于治疗2周后和治疗前,差异有统计学意义(P<0.05);观察组治疗2周后竖脊肌、多裂肌双侧RMS值高于治疗前,治疗后竖脊肌、多裂肌双侧RMS值高于治疗2周后和治疗前,差异有统计学意义(P<0.05);观察组治疗2周后、治疗后竖脊肌和多裂肌双侧RMS值高于对照组,差异有统计学意义(P<0.05)。两组治疗2周后竖脊肌、多裂肌双侧MF值高于治疗前,治疗后竖脊肌、多裂肌双侧MF值高于治疗2周后和治疗前,差异有统计学意义(P<0.05);观察组治疗2周后和治疗后竖脊肌、多裂肌双侧MF值高于对照组,差异有统计学意义(P<0.05)。结论电针联合SET训练能更好地减轻患者疼痛,改善椎旁核心肌(多裂肌、竖脊肌)的肌电信号,促进腰椎核心肌群功能恢复。
基金Supported by “The 12th five-year plan” programmed project of educational science in Hubei Province:2014B095
文摘Objective To observe the influence of different acupoint combinations on immediate effect of surface electromyography of patients with cervical spondylosis, and to explore the interactions and laws among different acupoint combinations. Methods Acupuncture in three kinds of different acupoint combinations was conducted on 90 patients with cervical spondylosis（three groups）： group A [distal point selection group： Kūnlún（昆仑 BL 60） and Hòuxī（后溪 SI 3）]; group B [local point selection group： Fēngchí（风池 GB 20） and Tiānzhù（天柱 BL 10）]; group C（distal and local point selection group： BL 60, SI 3, GB 20 and BL 10）. Self control before and after treatment was adopted to observe the mean value of surface electromyography（SEMG） amplitude, to measure the mean values of integrated electromyography（IEMG） and electromyography root mean square（RMS）, and to calculate the variation rate of electromyography amplitude of trapezius on the affected side of patients before and after acupuncture. The differences of influences of different acupoint combinations on immediate effect of surface electromyography were compared intra-group, and the differences among the three groups after acupuncture were also compared. Results According to the intragroup comparison before and after acupuncture, the differences of mean value of electromyography amplitude, variation rate of electromyography amplitude, IEMG and RMS were both statistically significant（all P〈0.05）. According to the inter-group comparison after acupuncture, the mean value of electromyography amplitude, variation rate of electromyography amplitude, IEMG and RMS varied in different degrees, however, the differences were not significant（all P〉0.05）; there was no significant difference in the total effective rate among the three groups（P〉0.05）. Conclusion Acupuncture treatment in different acupoint combinations can increase IEMG and RMS and reduce mean value of electromyography amplitude and variation rate of electromyography amplitude, enhance cervical vertebral stability and active contractility of muscle fiber, and improve the fatigue resistance of neck flexion; while, the therapeutic effect of acupuncture on cervical spondylosis has nothing to do with the distance or the number of selected acupoint.
文摘目的:探讨仰卧凌空直蹬腿锻炼对经椎间孔入路内镜下腰椎间盘切除术(transforaminal endoscopic lumbar discectomy,TELD)后患者肌群调控与筋骨平衡作用机制。方法:选取了2024年7月至2025年1月行TELD患者38例,根据TELD后锻炼方式不同分为功法组和飞燕组,各19例。两组患者于术后2周拆线后行4周的术后康复锻炼。功法组19例,男12例,女7例;左侧9例,右侧10例;年龄25~61(40.37±10.40)岁;手术节段在L_(4,5)的10例,L_(5)S_(1)的9例;身体质量指数(body mass index,BMI)为19.72~27.68(23.48±2.46)kg·m^(-2);采用仰卧凌空直蹬腿锻炼。飞燕组19例,男16例,女3例;左侧9例,右侧10例;年龄25~67(40.16±10.86)岁;手术节段在L_(4,5)的11例,在L_(5)S_(1)的8例;BMI为18.43~29.28(24.49±2.88)kg·m^(-2);采用“飞燕”式锻炼。比较两组锻炼前及锻炼4周后的疼痛视觉模拟评分(visual analogue scale,VAS)、腰椎功能障碍指数(Oswestry disability index,ODI),比较两组锻炼前后患侧的竖脊肌、腹直肌、股内侧肌、股外侧肌、腓肠肌的最大收缩值(maximal voluntary contraction,MVC)、肌电均方根值(root mean square,RMS)、积分肌电值(integral of the EMG signal,INT)、平均功率频率(mean power frequency,MPF)、RMS占最大自主收缩的百分比(RMS/MVC值,%MVC),比较两组锻炼前后患侧的竖脊肌、腹直肌、股内侧肌、股外侧肌、腓肠肌的肌肉肌张力F值(oscillation frequency),硬度S值(dynamic stiffness)和弹性D值(logarithmic decrement of a muscle's natural oscillation)。结果:功法组锻炼后VAS低于锻炼前,两组锻炼后ODI均低于锻炼前,差异有统计学意义(P<0.05);飞燕组锻炼后VAS与锻炼前比较,差异无统计学意义(P>0.05);功法组锻炼后VAS、ODI低于飞燕组,差异有统计学意义(P<0.05);功法组竖脊肌锻炼后RMS、INT、MPF、%MVC低于飞燕组,差异有统计学意义(P<0.05);功法组腹直肌锻炼后MVC、RMS、INT、%MVC高于飞燕组,MPF低于飞燕组,差异均有统计学意义(P<0.05);飞燕组竖脊肌锻炼后F、S值高于锻炼前,功法组腹直肌、股内侧肌、股外侧肌锻炼后D值均低于锻炼前,差异均有统计学意义(P<0.05)。结论:仰卧凌空直蹬腿运动可有效缓解术后疼痛,促进腰椎功能恢复,激活核心肌群,增强下肢肌群协同作用,改善肌肉张力、硬度和弹性,可为腰椎内镜术后康复锻炼提供新方案。
