Rapid muscle activation and force capacity in conditions of chronic musculoskeletal pain
Rapid muscle activation and force capacity in conditions of chronic musculoskeletal pain
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DOI：
10.1016/j.clinbiomech.2008.08.002
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发表时间：
2008-12-01
影响因子：
1.8
通讯作者：
Sjogaard, Gisela
中科院分区：
文献类型：
--
作者：
Andersen, Lars L.;Holtermann, Andreas;Sjogaard, Gisela
背景肌肉骨骼疼痛和最大肌力能力下降之间的关系已被广泛研究，但关于慢性肌肉骨骼疼痛条件下的功能性快速力量能力的知识缺乏。本研究的目的是研究慢性疼痛肌肉的快速肌肉激活和力量能力。横断面研究42名患有慢性斜方肌痛的女性和20名健康匹配的对照。最大容量被确定为最大自主外展肩部稳定高力阶段疼痛斜方肌和无痛三角肌的峰值扭矩和峰值肌电振幅，而快速容量被确定为扭矩-时间和肌电时间曲线的最陡斜率，定义为扭矩发展率和肌电上升率。在测试前用视觉模拟量表记录疼痛强度。与健康对照组相比，患有肌痛的女性在115肩关节角处的峰值扭矩降低18% (P < 0.001)，相应的肌电图峰值水平降低29%，特别是疼痛的斜方肌（P < 0.001）。扭矩发展速率降低了33-54% (P < 0.001)，疼痛的斜方肌和无痛的三角肌肌电图上升速率相应降低了21-35% （P < 0.0001）。疼痛强度与快速容量参数（R = -0.33 ~ -0.53, P < 0.001 ~ 0.05）的相关性高于与最大容量参数（R = -0.15 ~ -0.41, P < 0.01 ~ ns）的相关性。在慢性肌肉骨骼疼痛的情况下，快速激活疼痛和无痛协同肌肉的能力比最大肌肉激活更严重。这些发现对慢性疼痛肌肉的康复具有临床意义。(C) 2008 Elsevier Ltd版权所有。
Background The association between musculoskeletal pain and decreased maximal muscle strength capacity has been extensively studied, but knowledge about functional rapid force capacity in conditions of chronic musculoskeletal pain is lacking. The objective of this study is to investigate rapid muscle activation and force capacity of chronically painful muscles.Methods. Cross-sectional study with 42 women with chronic trapezius myalgia, and 20 healthy matched controls. Maximal capacity was determined as peak torque and peak EMG amplitude of the painful trapezius and painfree deltoid muscles during the stable high-force phase of maximal voluntary shoulder abduction, whereas rapid capacity was determined as the steepest slope of the torque-time and EMG-time curves, defined as rate of torque development and rate of EMG rise. Intensity of pain was registered prior to the test on a visual-analogue-scale.Findings. Peak torque was 18% lower at 115 shoulder joint angle in women with myalgia compared with healthy controls (P < 0.001), with a corresponding 29% lower level of peak EMG specifically of the painful trapezius muscle (P < 0.001). Rate of torque development was 33-54% lower (P < 0.001), with a corresponding 21-35% lower level of rate of EMG rise of both the painful trapezius and painfree deltoid (P < 0.0001). Intensity of pain showed higher association with parameters of rapid capacity (R = -0.33 to -0.53, P < 0.001-0.05) than with maximal capacity (R = -0.15 to -0.41, P < 0.01-ns).Interpretation. In conditions of chronic musculoskeletal pain, the ability to rapidly activate painful and painfree synergistic muscles is more severely impaired than maximal muscle activation. These findings have clinical relevance for rehabilitation of chronically painful muscles. (C) 2008 Elsevier Ltd. All rights reserved.