慢性腰痛患者深层多裂肌EMG信号时频特征变化
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摘要
目的:采用表面肌电(sEMG)分析系统结合丝电极观察慢性腰痛(cLBP)患者与健康对照者腰部深层多裂肌的肌电活动,比较二者的EMG信号时域和频域特征,探讨腰痛深层多裂肌功能状态变化。方法:选取22例cLBP患者(10男12女)和30例健康对照者(15男15女)采用一次性无菌针头导入不锈钢丝电极(直径0.16mm)至L4水平深层多裂肌后完成改良BST动作,采集多裂肌最大随意收缩时的EMG信号,比较两组平均肌电值(AEMG)、均方根值(RMS)、中位频率(MF)、平均功率频率(MPF)及其频率的特征差异。结果:cLBP腰部深层多裂肌EMG信号时域指标AEMG、RMS明显低于健康对照组(P<0.001);频域指标MF、MPF明显高于对照组(P<0.05),MFs、MPFs绝对值明显低于对照组(P=0.001/0.001)。结论:最大等长收缩运动中,cLBP患者腰部深层多裂肌电活动异常,可能是持续疼痛刺激引起多裂肌募集能力降低,耐力代偿性增加。
Objective: To explore time-frequency changes of electromyography(EMG) signals of the deep multifidus(DM)at the level of fourth lumbar vertebrae(L4) using the surface electromyography system and fine-wire electrodes in patients with chronic low back pain(cLBP).Method: Twenty-two patients with chronic low back pain(male, 10, female, 12) and thirty healthy controls(male, 15, female, 15) were recruited. To study the DM, nylon coated 12 cm long and 0.16 mm in diameter finewire electrodes with 5 mm nude tip were inserted into DM via a hypodermic needle(25 gauge,60 mm long).EMG signals of maximum isometric voluntary contraction of the DM were collected. The data were analyzed with independent samples t-test to compare time-frequency changes of EMG activity of the lumbar multifidus.Result: Compared with healthy controls,cLBP group showed significant decrease in AEMG and RMS(P<0.001),but increased in MF and MPF(P<0.05). Significant differences of time-domain parameters were found between bilateral DM of both groups(P<0.05). There were also statistically significant differences between the two groups in MF slope(MFs) and MPF slope(MPFs), where cLBP group demonstrated higher value than healthy control group(P=0.001/0.001).Conclusion: The findings reveal that cLBP alters the neuromuscular activation patterns of the DM, lowers its recruit ability and increases its endurance.
Objective: To explore time-frequency changes of electromyography(EMG) signals of the deep multifidus(DM)at the level of fourth lumbar vertebrae(L4) using the surface electromyography system and fine-wire electrodes in patients with chronic low back pain(cLBP).Method: Twenty-two patients with chronic low back pain(male, 10, female, 12) and thirty healthy controls(male, 15, female, 15) were recruited. To study the DM, nylon coated 12 cm long and 0.16 mm in diameter finewire electrodes with 5 mm nude tip were inserted into DM via a hypodermic needle(25 gauge,60 mm long).EMG signals of maximum isometric voluntary contraction of the DM were collected. The data were analyzed with independent samples t-test to compare time-frequency changes of EMG activity of the lumbar multifidus.Result: Compared with healthy controls,cLBP group showed significant decrease in AEMG and RMS(P<0.001),but increased in MF and MPF(P<0.05). Significant differences of time-domain parameters were found between bilateral DM of both groups(P<0.05). There were also statistically significant differences between the two groups in MF slope(MFs) and MPF slope(MPFs), where cLBP group demonstrated higher value than healthy control group(P=0.001/0.001).Conclusion: The findings reveal that cLBP alters the neuromuscular activation patterns of the DM, lowers its recruit ability and increases its endurance.
引文
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[3]张珊珊,吴文,许轶,等.不同性别健康人群腰部深层多裂肌EMG差异[J].中国康复医学杂志, 2018, 33(4):413—418.
[4]吴文,黄国志,刘湘江.表面肌电图用于腰椎间盘突出疗效评定研究[J].中华物理医学和康复杂志, 2002, 4(9):551—553.
[5] Kamaz M, Kire?i D. CT measurement of trunk muscle areas in patients with chronic low back pain[J]. Diagn Interv Radiol, 2007, 13(3):144—148.
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[7] Demoulin C, Crielaard JM, Vanderthommen M. Spinal muscle evaluation in healthy individuals and low-back-pain patients:a literature review[J]. Joint Bone Spine, 2007, 74(1):9—13.
[8] Suehiro T, Mizutani M, Ishida H, et al. Individuals with chronic low back pain demonstrate delayed onset of the back muscle activity during prone hip extension[J]. J Electromyogr Kinesiol, 2015, 25(4):675—680.
[9] Silfies SP, Squillante D, Maurer P, et al. Trunk muscle recruitment patterns in specific chronic low back pain populations[J]. Clin Biomech(Bristol, Avon), 2005, 20(5):465—473.
[10] Danneels LA, Vanderstraeten GG, Cambier DC, et al. A functional subdivision of hip, abdominal, and back muscles during asymmetric lifting[J]. Spine,2001, 26(5):E114—121.
[11] Freeman MD, Woodham MA, Woodham AW. The role of the lumbar multifidus in chronic low back pain:a review[J]. PMR, 2010, 2(2):142—146.
[12]穆景颂,倪朝民,夏清,等.表面肌电在腰椎间盘突出症患者功能评定中的应用[J].中国康复理论与实践, 2010, 16(3):266—269.
[13]王健,方红光, Kankaanpaa M.基于表面肌电信号变化的慢性下背痛诊断和运动疗效评价[J].航天医学与医学工程,2005, 18(4):287—292.
[2] Macdonald DA, Dawson AP, Hodges PW. Behavior of the lumbar multifidus during lower extremity movements in people with recurrent low back pain during symptom remission[J]. J Orthop Sports Phys Ther, 2011, 41(3):155—164.
[3]张珊珊,吴文,许轶,等.不同性别健康人群腰部深层多裂肌EMG差异[J].中国康复医学杂志, 2018, 33(4):413—418.
[4]吴文,黄国志,刘湘江.表面肌电图用于腰椎间盘突出疗效评定研究[J].中华物理医学和康复杂志, 2002, 4(9):551—553.
[5] Kamaz M, Kire?i D. CT measurement of trunk muscle areas in patients with chronic low back pain[J]. Diagn Interv Radiol, 2007, 13(3):144—148.
[6] Hides J, Gilmore C, Stanton W, et al. Multifidus size and symmetry among chronic LBP and healthy asymptomatic subjects[J]. Man Ther, 2008, 13(1):43—49.
[7] Demoulin C, Crielaard JM, Vanderthommen M. Spinal muscle evaluation in healthy individuals and low-back-pain patients:a literature review[J]. Joint Bone Spine, 2007, 74(1):9—13.
[8] Suehiro T, Mizutani M, Ishida H, et al. Individuals with chronic low back pain demonstrate delayed onset of the back muscle activity during prone hip extension[J]. J Electromyogr Kinesiol, 2015, 25(4):675—680.
[9] Silfies SP, Squillante D, Maurer P, et al. Trunk muscle recruitment patterns in specific chronic low back pain populations[J]. Clin Biomech(Bristol, Avon), 2005, 20(5):465—473.
[10] Danneels LA, Vanderstraeten GG, Cambier DC, et al. A functional subdivision of hip, abdominal, and back muscles during asymmetric lifting[J]. Spine,2001, 26(5):E114—121.
[11] Freeman MD, Woodham MA, Woodham AW. The role of the lumbar multifidus in chronic low back pain:a review[J]. PMR, 2010, 2(2):142—146.
[12]穆景颂,倪朝民,夏清,等.表面肌电在腰椎间盘突出症患者功能评定中的应用[J].中国康复理论与实践, 2010, 16(3):266—269.
[13]王健,方红光, Kankaanpaa M.基于表面肌电信号变化的慢性下背痛诊断和运动疗效评价[J].航天医学与医学工程,2005, 18(4):287—292.