Do Neuromuscular Alterations Exist for Patients With Acetabular Labral Tears During Function?
Do Neuromuscular Alterations Exist for Patients With Acetabular Labral Tears During Function?
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功能过程中髋臼唇撕裂患者是否存在神经肌肉改变？
DOI：
10.1016/j.arthro.2016.03.016
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发表时间：
2016-06
期刊：
影响因子：
--
通讯作者：
McCarthy JC
中科院分区：
文献类型：
--
作者：
Dwyer MK;Lewis CL;Hanmer AW;McCarthy JC
我们研究的目的是确定与无症状对照受试者相比，有症状的盂唇撕裂患者在弓步过程中接触力和肌电图（EMG）肌肉振幅是否发生变化。将表面肌电电极放置在患者患肢和无症状对照者的匹配肢体的臀中肌、臀大肌、长收肌和股直肌上。受试者在临床力量平台上进行了三次弓步试验。在测试过程中，电测角仪跟踪膝关节屈曲运动。计算每个肌肉的平均均方根EMG肌肉振幅的下降和上升阶段的弓步，表示为最大活动的百分比（%MVIC）。根据测角器计算膝关节屈曲峰值（°）。来自测力平台的因变量为弓步距离（%高度）、接触时间（秒）、垂直冲击力（%BW）和力脉冲（%BW* 秒）。使用独立样本t检验或Mann-Whitney U检验比较组间因变量。用斯皮尔曼Rho相关系数评估因变量之间的关系。显著性水平设定为p≤0.05。21例有症状的单侧盂唇撕裂患者（14例女性，7例男性）和17例无症状的对照受试者（11例女性，6例男性）参加了本研究。在弓步上升过程中，与无症状对照组相比，有症状盂唇患者的平均臀大肌EMG肌肉振幅降低（51.6 ± 31.1 vs. 71.7 ± 36.3; [MD：20.1%（− 2.4%，42.6%）]; p=0.042）。平均垂直冲击力降低（21.8 ± 5.5 vs. 26.8 ± 7.3; [MD：5.1%BW（0.84%BW，9.3%BW）]; p=0.02）和平均接触时间（1.8 ± 0.4 vs. 1.5 ± 0.4; [MD：0.27 s（0.006 sec，0.54 sec）]; p=0.045）和力脉冲[188.4 ± 42.4 vs. 162.6 ± 33.3; [MD：25.8%BW*s（0.3%BW*s，51.4%BW*s）]; p=0.042]与无症状对照组相比，有症状盂唇患者的平均体重增加。对于有症状的盂唇患者，在弓步下降过程中，垂直冲击力与臀中肌振幅呈负相关（r =-0.452; p=0.045）。我们的研究表明，接触力和肌电图肌肉振幅的改变，在弓步的患者有症状的唇撕裂。肌肉振幅和接触力之间存在关系表明，靶向肌肉损伤可能会恢复这些患者的功能。
The purpose of our study was to determine if contact forces and electromyography (EMG) muscle amplitudes were altered during the lunge for patients with symptomatic labral tears compared to asymptomatic control subjects. Surface electromyography electrodes were placed over the gluteus medius, gluteus maximus, adductor longus, and rectus femoris muscles of the patients' involved limb and matched limb of asymptomatic controls. Subjects performed three trials of the lunge on a clinical force platform. An electrogoniometer tracked knee flexion motion during testing. Average root-mean squared EMG muscle amplitudes for each muscle were calculated for the descent and ascent phases of the lunge, represented as a percent of maximum activity (%MVIC). Peak knee flexion was calculated from the goniometer(°). The dependent variables from the force platform were lunge distance(%height), contact time(seconds), vertical impact force(%BW), and force impulse(%BW*seconds). Dependent variables were compared between groups using either independent samples t-tests or Mann-Whitney U tests. Relationships between dependent variables were assessed with Spearman Rho correlation coefficients. The level of significance was set at p≤0.05. Twenty-one patients with symptomatic unilateral labral tears (14 females, 7 males) and 17 asymptomatic control subjects (11 females, 6 males) participated in this study. Average gluteus maximus EMG muscle amplitudes were reduced for symptomatic labral patients compared to asymptomatic controls during lunge ascent (51.6 ± 31.1 vs. 71.7 ± 36.3; [MD: 20.1% (−2.4%, 42.6%)]; p=0.042). Average vertical impact force was reduced (21.8 ± 5.5 vs. 26.8 ± 7.3; [MD: 5.1%BW (0.84%BW, 9.3%BW)]; p=0.02) and average contact time (1.8 ± 0.4 vs. 1.5 ± 0.4; [MD: 0.27s (0.006sec, 0.54sec)]; p=0.045) and force impulse (188.4 ± 42.4 vs. 162.6 ± 33.3; [MD: 25.8%BW*s (0.3%BW*s, 51.4%BW*s)]; p=0.042) were increased for symptomatic labral patients compared to asymptomatic controls. Vertical impact force was inversely correlated with gluteus medius muscle amplitudes during lunge descent for symptomatic labral patients (r = −0.452; p=0.045). Our study demonstrates that contact forces and EMG muscle amplitudes are altered during the lunge for patients with symptomatic labral tears. The presence of a relationship between muscle amplitudes and contact forces suggests that targeting muscle impairments may restore function in these patients.
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作者：
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影响因子：
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