Jinping Li, Na Zhang, Ying Xu, Juan Wang, Xianglian Kang, Runing Ji, Ke Li, Ying Hou
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引用次数: 0
Abstract
Background: A given movement requires precise coordination of multiple muscles under the control of center nervous system. However, detailed knowledge about the changing characteristics of neuromuscular control for multi-muscle coordination in post-stroke hemiplegic patients during standing is still lacking. This study aimed to investigate the hemiplegia-linked neuromuscular dysfunction during standing from the perspective of multi-muscle dynamical coordination by utilizing a novel network approach - weighted recurrence network (WRN).
Methods: Ten male hemiplegic patients with first-ever stroke and 10 age-matched healthy male adults were instructed to stand on a platform quietly for 30 s with eyes opened and eyes closed, respectively. The WRN was constructed based on the surface electromyography signals of 16 muscles from trunk, hips, thighs and calves. Relevant topological parameters, including clustering coefficient (C) and average shortest path length (L), were extracted to evaluate the dynamical coordination of multiple muscles. A measure of node centrality in network theory, degree of centrality (DC), was innovatively introduced to assess the contribution of single muscle in the multi-muscle dynamical coordination. The standing-related assessment metric, center of pressure (COP), was provided by the platform directly.
Results: Results showed that the post-stroke hemiplegic patients stood with remarkably higher similarity of muscle activation and more coupled intermuscular dynamics, characterized by higher C and lower L than the healthy subjects (p < 0.05). The DC values and rankings of back, hip and calf muscles on the affected side were significantly decreased, whereas those on the unaffected side were significantly increased in hemiplegia group compared with the healthy group (p < 0.05). Without visual feedback, subjects exhibited enhanced muscle coordination and increased muscle involvement (p < 0.05). A decrease in C and an increase in L of WRN were observed with decreased COP areas (p < 0.05).
Conclusions: These findings revealed that stroke-induced hemiplegia could significantly influence the neuromuscular control, which was manifested as more coupled intermuscular dynamics, abnormal deactivation of muscles on affected side and compensation of muscles on unaffected side from the perspective of multi-muscle coordination. Enhanced multi-muscle dynamical coordination was strongly associated with impaired postural control. This study provides a novel analytical tool for evaluation of neuromuscular dysfunction and specification of responsible muscles for impaired postural control in stroke-induced hemiplegic patients, and could be potentially applied in clinical practice.
背景:一个特定的动作需要在中枢神经系统的控制下精确协调多块肌肉。然而,有关中风后偏瘫患者站立时多肌肉协调的神经肌肉控制变化特征的详细知识仍然缺乏。本研究旨在利用新型网络方法--加权复发网络(WRN),从多肌肉动态协调的角度研究站立时与偏瘫相关的神经肌肉功能障碍:方法:让 10 名首次中风的男性偏瘫患者和 10 名年龄匹配的健康男性成年人分别睁眼和闭眼在平台上安静站立 30 秒。根据躯干、臀部、大腿和小腿 16 块肌肉的表面肌电信号构建 WRN。提取了相关的拓扑参数,包括聚类系数(C)和平均最短路径长度(L),以评估多块肌肉的动态协调性。创新性地引入了网络理论中的节点中心度(DC)来评估单块肌肉在多块肌肉动态协调中的贡献。平台直接提供了与站立相关的评估指标--压力中心(COP):结果表明,与健康人相比,中风后偏瘫患者站立时肌肉激活的相似性明显更高,肌肉间动力学耦合性更强,表现为更高的 C 值和更低的 L 值(p 结论:中风后偏瘫患者站立时肌肉激活的相似性明显更高,肌肉间动力学耦合性更强,表现为更高的 C 值和更低的 L 值:这些发现揭示了脑卒中引起的偏瘫会显著影响神经肌肉控制,从多肌肉协调的角度来看,表现为更多的耦合肌间动力学、患侧肌肉异常失活和未受影响侧肌肉的代偿。多肌肉动态协调的增强与姿势控制受损密切相关。这项研究为评估中风偏瘫患者的神经肌肉功能障碍和确定姿势控制受损的责任肌肉提供了一种新的分析工具,并有可能应用于临床实践。
期刊介绍:
Journal of NeuroEngineering and Rehabilitation considers manuscripts on all aspects of research that result from cross-fertilization of the fields of neuroscience, biomedical engineering, and physical medicine & rehabilitation.