Alterations in lower limb multimuscle activation patterns during stair climbing in female total knee arthroplasty patients
Alterations in lower limb multimuscle activation patterns during stair climbing in female total knee arthroplasty patients
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DOI：
10.1152/jn.00370.2015
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发表时间：
2015-11-01
影响因子：
2.5
通讯作者：
Ronsky, J. L.
中科院分区：
文献类型：
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作者：
Kuntze, G.;von Tscharner, V.;Ronsky, J. L.
全膝关节置换术(TKA)患者通常会经历神经肌肉适应，这可能会影响爬楼梯能力。本研究利用支持向量机对女性全膝关节置换术患者术后爬楼梯过程中的多肌模式变化进行了研究。这是假设，TKA患者采用时间和光谱的肌肉激活特征，表明肌肉萎缩和协同收缩策略。女性受试者19例[单侧TKA 10例，62.2+/-8.6岁，体质量指数28.2+/-5.4 kg/m(2例)；健康对照组9例，61.4+/-7.4岁，BMI 25.6+/-2.4 kg/m(2例)]。对TKA患者的7条患肢和随机分配的对照肢体在爬楼梯过程中进行了表面肌电(EMG)检测。对站姿相(+/-30%)肌电数据进行小波变换并归一化为总功率。所有肌肉的数据被组合成MMPs，并用支持向量机进行分析。统计分析采用SPSS软件中的二项检验、独立组t检验或独立组Mann-Whitney U检验(P<；0.05)。支持向量机结果显示，TKA组的股二头肌(识别率为84.2%)、半腱肌群(识别率为73.7%)、腓肠肌(识别率为68.4%)和胫骨前肌(识别率为68.4%)的肌肉激活模式发生了显著变化。进一步的分析发现，不同组之间的光谱激活特征没有显著差异。然而，时间适应，表明共收缩策略，在TKA MMP中是明显的。该方法为临床神经肌肉功能评估和康复监测提供了有价值的工具。
Total knee arthroplasty (TKA) patients commonly experience neuromuscular adaptations that may affect stair climbing competence. This study identified multimuscle pattern (MMP) changes in postoperative female TKA patients during stair climbing with a support vector machine (SVM). It was hypothesized that TKA patients adopt temporal and spectral muscle activation characteristics indicative of muscle atrophy and cocontraction strategies. Nineteen female subjects [10 unilateral sex-specific TKAs, 62.2 +/- 8.6 yr, body mass index (BMI) 28.2 +/- 5.4 kg/m(2); 9 healthy control subjects, 61.4 +/- 7.4 yr, BMI 25.6 +/- 2.4 kg/m(2)] were recruited. Surface electromyograms (EMGs) were obtained for seven lower limb muscles of the affected limb of TKA subjects and a randomly assigned limb for control subjects during stair climbing. Stance phase (+/- 30%) EMG data were wavelet transformed and normalized to total power. Data across all muscles were combined to form MMPs and analyzed with a SVM. Statistical analysis was performed with binomial tests, independent group t-tests, or independent group Mann-Whitney U-tests in SPSS (P < 0.05). SVM results indicated significantly altered muscle activation patterns in the TKA group for biceps femoris (recognition rate 84.2%), semitendinosus (recognition rate 73.7%), gastrocnemius (recognition rate 68.4%), and tibialis anterior (recognition rate 68.4%). Further analysis identified no significant differences in spectral activation characteristics between groups. Temporal adaptations, indicative of cocontraction strategies, were, however, evident in TKA MMPs. This approach may provide a valuable tool for clinical neuromuscular function assessment and rehabilitation monitoring.