Postural Control Strategies Related to Anticipatory Perturbation and Quick Perturbation in Adolescent Idiopathic Scoliosis
Postural Control Strategies Related to Anticipatory Perturbation and Quick Perturbation in Adolescent Idiopathic Scoliosis
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DOI：
10.1097/brs.0b013e3181d0f80c
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发表时间：
2011-05-01
期刊：
影响因子：
3
通讯作者：
Tan, Shih-Hsin
中科院分区：
文献类型：
--
作者：
Kuo, Fang-Chuan;Hong, Chang-Zern;Tan, Shih-Hsin
研究设计。横断面研究：目的。目的：探讨青少年特发性脊柱侧凸(AIS)患者与预期干扰(AP)和快速后向干扰相关的自动平衡矫正。以往对AIS患者的研究大多集中在体位摆动上，缺乏对动态站立对照中肌肉激活模式的分析。32名AIS患者和23名年龄匹配的正常受试者在不稳定的平台上接受了扰动平衡测试。记录平台倾斜角和双侧腰椎多裂肌、臀中肌、腓肠肌的肌力。肌电(EMG)波幅、起搏潜伏期、持续时间随机载软件计算。在两种扰动条件下，AIS组的姿势倾斜程度均低于正常受试者，但肌肉活动强度高于正常受试者(P<；0.05)。在AP试验中，AIS显示左侧多裂肌和右侧腓肠肌的起搏时间早，激活时间延长(P<；0.05)。腰椎凸侧多裂潜伏期早于凹侧。然而，在AIS组，腓肠肌的不对称起效时间与多裂肌的起效时间相反(P<；0.05)。与AP情况相比，AIS组双侧腿部和躯干肌肉激活的潜伏期和持续时间相似(P<；0.05)。在快速后向摄动试验中，对照组右侧多裂肌和双侧腓肠肌的活动持续时间长于AIS，以应对较大的平台倾斜。另外，对照组的臀中肌起效不对称，多裂持续时间长(P<；0.05)。AIS受试者的姿势控制模式与正常受试者有显著差异。AIS受试者对AP有不对称的习惯性肌肉活动，而当应对突然的平衡威胁时，他们的反应是双侧姿势肌肉的同步招募。
Study Design. Cross-sectional study.Objective. To investigate the automatic balance correction related to anticipatory perturbation (AP) and quick backward perturbation in adolescent idiopathic scoliosis (AIS).Summary of Background Data. Most previous studies on AIS patients focused on posture sway and lacked analysis of muscle activated patterns in dynamic standing control.Methods. Thirty-two AIS patients and 23 age-matched normal subjects received perturbation balance tests on an unstable platform. The tilting angle of the platform and the muscle activity of the bilateral lumbar multifidi, gluteus medii, and gastrocnemii muscles were recorded. Electromyographic (EMG) amplitude, onset latencies, and duration were calculated with software accompanied with machine.Results. The AIS group had less posture tilting but higher muscle activities than normal subjects under both perturbation conditions (P < 0.05). Under the AP test, AIS showed earlier onset and prolonged activation of left multifidus and right gastrocnemius compared with normal subjects (P < 0.05). The latency of the multifidus on the lumbar convex side occurred earlier than on the concave side. However, the asymmetric onset timing of the gastrocnemius was the opposite of the multifidi in the AIS group (P < 0.05). In contrast to the AP condition, bilateral leg and trunk muscles activated at similar latencies and durations in the AIS group (P < 0.05). Under the quick backward perturbation test, the control group had longer active duration of right multifidus and bilateral gastrocnemii than AIS to cope with larger platform tilting. In addition, asymmetric onset of gluteus medii and duration of multifidi was observed in the control group (P < 0.05).Conclusion. There were significant differences in posture control patterns between AIS and normal subjects. AIS subjects have asymmetric habitual muscle activities for AP, whereas when coping with sudden balance threats, they react with synchronized recruitment of bilateral postural muscles.