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Pelvic floor muscle electrical coupling in chronic pelvic pain: Insights into pathophysiology and botulinum toxin treatment effects 慢性盆腔痛中的盆底肌电耦合:对病理生理学和肉毒毒素治疗效果的见解。
IF 2 4区 医学 Q3 NEUROSCIENCES Pub Date : 2024-10-11 DOI: 10.1016/j.jelekin.2024.102940
Monica Albaladejo-Belmonte , Marta Tarazona-Motes , Francisco Jose Nohales-Alfonso , Maria De-Arriba , Jose Alberola-Rubio , Javier Garcia-Casado
This study aimed to assess the electrical coupling between both pelvic floor muscle (PFM) sides (two-sided coupling) and within individual PFM sides (one-sided coupling) in chronic pelvic pain (CPP) before and after botulinum neurotoxin type A (BoNT/A) treatment. Surface electromyographic (sEMG) signals were recorded from the left and right PFM of 24 patients (P) with CPP before and after being treated with BoNT/A (Weeks 0,8,12,24). Recordings were also made in 24 healthy women (H). PFM two-sided and one-sided coupling was evaluated during contractions by the cross-correlation (CC) and the imaginary part of coherency (iCOH) of their sEMG signals. Significant differences between their values were assessed comparing P(0) vs. P(8,12,24) and H vs. P(0,8,12,24). This study showed that PFM two-sided coupling is similar across groups before treatment, while PFM one-sided coupling on the patients’ most painful side is deranged before and also after BoNT/A treatment: amplitude coupling is lower (<CC) and phase difference is greater (>iCOH) than healthy women’s. This could be justified by altered neuromotor control strategies developed as an adaptation to muscle pain, structural and electrical changes in PFM, and alterations in their innervation pattern, which may influence the onset, perpetuation, or recurrence of CPP after treatment.
本研究旨在评估 A 型肉毒杆菌神经毒素(BoNT/A)治疗前后慢性盆底痛(CPP)患者盆底肌(PFM)两侧之间(两侧耦合)和盆底肌单侧内部(单侧耦合)的电耦合情况。在接受 BoNT/A 治疗前后(第 0、8、12、24 周),记录了 24 名 CPP 患者(P)左右两侧 PFM 的表面肌电图(sEMG)信号。同时还对 24 名健康女性(H)进行了记录。在收缩期间,通过其 sEMG 信号的交叉相关性(CC)和假想部分一致性(iCOH)评估 PFM 两侧和单侧耦合。通过比较 P(0) vs. P(8,12,24) 和 H vs. P(0,8,12,24) 来评估它们之间的显著差异。这项研究表明,治疗前各组的 PFM 双侧耦合相似,而在 BoNT/A 治疗前和治疗后,患者最疼痛一侧的 PFM 单侧耦合失常:振幅耦合(iCOH)低于健康女性。这可能是由于适应肌肉疼痛的神经运动控制策略发生了改变、PFM 的结构和电气发生了变化以及其神经支配模式发生了改变,这些可能会影响治疗后 CPP 的发生、持续或复发。
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引用次数: 0
The effect of tongue-to-palate on deep neck flexor activity 舌对腭对颈深屈肌活动的影响
IF 2 4区 医学 Q3 NEUROSCIENCES Pub Date : 2024-10-10 DOI: 10.1016/j.jelekin.2024.102938
Rebecca Sherwin , Janis Henricksen , Jeegisha Kapila , Lauren Adams , Aaron Likness , Troy L. Hooper , Phil Sizer
Deep neck flexor (DNF) muscles contribute to cervical stability and proprioception. Reduced muscle strength and endurance lead to faulty movement patterns, muscle imbalances, and dysfunction. Potentially, the orofacial muscles contribute to cervical strength by providing stability through muscular connections. This study examined effects of tongue muscle activity on cervical spine muscular stiffness. Twenty-three healthy subjects assumed three supine positions [at rest (AR), chin tuck (CT), and head lift (HL)] with and without tongue-to-palate pressure. The DNF stiffness was measured using shear wave elastography. Without tongue-to-palate, stiffness increased with CT and HL compared to AR (p <0.001) but not between CT and HL (p = 0.22). Tongue-to-palate increased stiffness AR (p <0.001) but not during CT (p = 0.95) or HL (p = 0.67). Stiffness levels between the AR and HL conditions during tongue-to-palate performance did not differ (p = 0.734), but CT stiffness was significantly greater than AR (p = 0.029) with tongue-to-palate. Tongue-to-palate AR increases DNF stiffness to a similar level as HL with or without tongue-to-palate, while CT with or without tongue-to-palate resulted in the highest stiffness levels. Tongue-to-palate pressure AR or with CT performance may be alternatives to HL strengthening in healthy necks. This may be a useful strategy to increase cervical stability during loads on the cervical spine.
颈部深屈肌(DNF)有助于颈椎的稳定性和本体感觉。肌肉力量和耐力下降会导致错误的运动模式、肌肉失衡和功能障碍。口面部肌肉可能通过肌肉连接提供稳定性,从而增强颈椎力量。本研究探讨了舌肌活动对颈椎肌肉僵硬度的影响。23 名健康受试者采取了三种仰卧姿势[静止 (AR)、收颏 (CT) 和抬头 (HL)],分别施加和不施加舌对腭压力。使用剪切波弹性成像技术测量 DNF 的硬度。在没有舌抵腭的情况下,CT 和 HL 的僵硬度比 AR 增加(p <0.001),但 CT 和 HL 之间的僵硬度没有增加(p = 0.22)。舌到腭会增加 AR 的僵硬度(p <0.001),但 CT(p = 0.95)或 HL(p = 0.67)时不会。在舌到腭时,AR 和 HL 条件下的僵硬度水平没有差异(p = 0.734),但在舌到腭时,CT 的僵硬度明显高于 AR(p = 0.029)。舌到腭的 AR 使 DNF 硬度增加到与带或不带舌到腭的 HL 相似的水平,而带或不带舌到腭的 CT 则导致最高的硬度水平。在健康的颈部,舌腭压力 AR 或 CT 性能可替代 HL 强化。这可能是在颈椎承受负荷时增强颈椎稳定性的有效策略。
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引用次数: 0
Upper extremity neuromuscular function can distinguish between individuals with and without glenohumeral labral repair 上肢神经肌肉功能可区分盂唇修复和未修复的个体
IF 2 4区 医学 Q3 NEUROSCIENCES Pub Date : 2024-09-24 DOI: 10.1016/j.jelekin.2024.102935
Katsumi Takeno , Christopher D. Ingersoll , Neal R. Glaviano , Sadik Khuder , Grant E. Norte
The purpose of this study was to determine whether common measures of neuromuscular function could distinguish injury status indicated by group membership (glenohumeral labral repair, uninjured controls). 16 individuals with glenohumeral labral repair (24.1 ± 5.0 years, 36.7 ± 33.3 months after surgery) and 14 uninjured controls (23.8 ± 2.7 years) volunteered. We measured mass-normalized shoulder abduction and wrist flexion maximal voluntary isometric contraction torque (Nm/kg), motoneuron pool excitability of the flexor carpi radialis (Hoffmann reflex), corticospinal excitability of the upper trapezius, middle deltoid, and flexor carpi radialis (active motor threshold [%]) bilaterally. Receiver operator characteristic curve analyses were performed to determine if each outcome could distinguish injury status along with their outcome thresholds. Binary logistic regression was used to determine the accuracy of classification for each outcome. Our results suggest shoulder abduction torque symmetry (≤95.5 %) and corticospinal excitability for the upper trapezius (≥41.0 %) demonstrated excellent diagnostic utility. Shoulder abduction torque (≤0.71 Nm/kg) and motoneuron pool excitability (≤0.23) demonstrated acceptable diagnostic utility. Shoulder abduction torque symmetry alone was the strongest indicator, and classified injury status with 90.0 % accuracy (p < 0.01). Overall, symmetric shoulder abduction strength most accurately distinguished individuals’ injury status, suggesting the utility of bilateral assessment in this population.
本研究的目的是确定神经肌肉功能的常见测量方法是否能够区分以组别(盂肱唇修复术、未受伤对照组)表示的受伤状态。16名盂盂关节唇修复患者(24.1 ± 5.0岁,术后36.7 ± 33.3个月)和14名未受伤的对照组患者(23.8 ± 2.7岁)自愿参加了这项研究。我们测量了质量标准化肩关节外展和腕关节屈曲最大自主等长收缩力矩(牛顿米/千克)、腕屈肌运动神经元池兴奋性(霍夫曼反射)、双侧斜方肌上部、三角肌中部和腕屈肌的皮质神经元兴奋性(主动运动阈值 [%])。为了确定每种结果是否能区分损伤状态及其结果阈值,进行了接收者操作特征曲线分析。二元逻辑回归用于确定每种结果的分类准确性。我们的结果表明,肩关节外展扭力对称性(≤95.5%)和斜方肌上部的皮质脊髓兴奋性(≥41.0%)具有极佳的诊断效用。肩关节外展扭矩(≤0.71 牛米/公斤)和运动神经元池兴奋性(≤0.23)的诊断效用可接受。仅肩关节外展扭矩对称性是最强的指标,对损伤状态的分类准确率为 90.0 %(p < 0.01)。总体而言,对称性肩关节外展力量最能准确区分个人的损伤状况,这表明在该人群中进行双侧评估是有用的。
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引用次数: 0
Do maximal isometric trunk tasks produce maximum activity in latissimus dorsi? 最大等距躯干任务是否会产生背阔肌的最大活动量?
IF 2 4区 医学 Q3 NEUROSCIENCES Pub Date : 2024-09-24 DOI: 10.1016/j.jelekin.2024.102933
Declan Price , Karen A. Ginn , Mark Halaki , Victor Kwasi , Darren Reed

Introduction

Electromyography (EMG) studies investigating latissimus dorsi activity during trunk tasks have reported high activation levels and described latissimus dorsi as an important contributor to trunk movement and stability. However, the normalisation of EMG data in these studies is inconsistent with some normalising to shoulder tasks and a majority normalising to trunk tasks. Therefore, this study aimed to compare commonly used shoulder and trunk normalisation tasks to determine if trunk tasks produce maximum activity in latissimus dorsi.

Methods

Ten asymptomatic participants completed maximal isometric trunk (extension, ipsilateral rotation and ipsilateral lateral flexion) and shoulder (extension and internal rotation) tasks while recording EMG signals from right latissimus dorsi using surface and indwelling electrodes. The signals were high-pass filtered, rectified then low-pass filtered to obtain an EMG linear envelope to represent muscle activity levels. The maximum activity levels across tasks were compared for each electrode type.

Results

Shoulder extension elicited significantly higher (>1.5 times) latissimus dorsi activity levels when recorded using both surface and indwelling electrodes compared to other shoulder and trunk tasks.

Conclusion

Maximal isometric trunk tasks do not produce maximal latissimus dorsi activity and therefore when used for normalisation purposes potentially overestimate the contribution of latissimus dorsi to trunk tasks.
简介:对躯干任务期间背阔肌活动进行的肌电图(EMG)研究报告了高激活水平,并将背阔肌描述为躯干运动和稳定性的重要贡献者。然而,这些研究中 EMG 数据的归一化并不一致,有些归一化为肩部任务,而大多数归一化为躯干任务。因此,本研究旨在比较常用的肩部和躯干归一化任务,以确定躯干任务是否会产生背阔肌的最大活动:方法:10 名无症状的参与者完成最大等长躯干(伸展、同侧旋转和同侧侧屈)和肩部(伸展和内旋)任务,同时使用表面和留置电极记录右侧背阔肌的肌电信号。信号经过高通滤波、整流和低通滤波后,得到一个代表肌肉活动水平的肌电图线性包络。比较了每种电极类型在不同任务中的最大活动水平:结果:与其他肩部和躯干任务相比,使用表面电极和留置电极记录肩部伸展时,背阔肌活动水平明显更高(>1.5 倍):结论:最大等长躯干任务不会产生最大背阔肌活动,因此当用于归一化目的时,可能会高估背阔肌对躯干任务的贡献。
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引用次数: 0
High-density EMG reveals atypical spatial activation of the gastrocnemius during walking in adolescents with Cerebral Palsy 高密度肌电图显示脑瘫青少年行走时腓肠肌的非典型空间激活。
IF 2 4区 医学 Q3 NEUROSCIENCES Pub Date : 2024-09-20 DOI: 10.1016/j.jelekin.2024.102934
Maxwell Thurston , Mika Peltoniemi , Alessandra Giangrande , Ivan Vujaklija , Alberto Botter , Juha-Pekka Kulmala , Harri Piitulainen
Children with Cerebral Palsy (CP) exhibit less-selective, simplified muscle activation during gait due to injury of the developing brain. Abnormal motor unit recruitment, altered excitation-inhibition balance, and muscle morphological changes all affect the CP electromyogram. High-density surface electromyography (HDsEMG) has potential to reveal novel manifestations of CP neuromuscular pathology and functional deficits by assessing spatiotemporal details of myoelectric activity. We used HDsEMG to investigate spatial-EMG distribution and temporal-EMG complexity of gastrocnemius medialis (GM) muscle during treadmill walking in 11 adolescents with CP and 11 typically developed (TD) adolescents.
Our results reveal more-uniform spatial-EMG amplitude distribution across the GM in adolescents with CP, compared to distal emphasis in TD adolescents. More-uniform spatial-EMG was associated with stronger ankle co-contraction and spasticity. CP adolescents exhibited a non-significant trend towards elevated EMG-temporal complexity. Homogenous spatial distribution and disordered temporal evolution of myoelectric activity in CP suggests less-structured and desynchronized recruitment of GM motor units, in combination with muscle morphological changes. Using HDsEMG, we uncovered novel evidence of atypical spatiotemporal activation during gait in CP, opening paths towards deeper understanding of motor control deficits and better characterization of changes in muscular activation from interventions.
由于发育中的大脑受到损伤,脑性瘫痪(CP)儿童在步态过程中表现出选择性较低、肌肉激活简化的特点。异常的运动单位募集、兴奋-抑制平衡的改变以及肌肉形态的变化都会影响 CP 肌电图。高密度表面肌电图(HDsEMG)可通过评估肌电活动的时空细节,揭示 CP 神经肌肉病理和功能障碍的新表现。我们使用 HDsEMG 研究了 11 名患有 CP 的青少年和 11 名发育正常(TD)的青少年在跑步机行走过程中腓肠肌内侧(GM)肌肉的空间-EMG 分布和时间-EMG 复杂性。我们的研究结果表明,与 TD 青少年的远端重点相比,CP 青少年腓肠肌的空间-EMG 振幅分布更加均匀。更均匀的空间-EMG 与更强的踝关节共收缩和痉挛有关。CP青少年的EMG-时间复杂性呈上升趋势,但不明显。脊髓灰质炎患者肌电活动的均匀空间分布和无序时间演变表明,结合肌肉形态学变化,GM 运动单元的招募缺乏结构性和非同步性。通过使用 HDsEMG,我们发现了 CP 患者步态期间非典型时空激活的新证据,为深入了解运动控制缺陷和更好地描述干预措施引起的肌肉激活变化开辟了道路。
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引用次数: 0
Effects of biofeedback and strength training interventions on neck-shoulder sensory-motor responses among visual display unit users. A narrative review 生物反馈和力量训练干预对视觉显示器使用者颈肩感觉运动反应的影响。叙述性综述
IF 2 4区 医学 Q3 NEUROSCIENCES Pub Date : 2024-09-20 DOI: 10.1016/j.jelekin.2024.102936
Pascal Madeleine , Grace P.Y. Szeto , Alberto Marcos Heredia-Rizo
Workplace biofeedback and strength training interventions have been conducted to treat neck-shoulder pain among visual display unit users. Biofeedback has been given using surface electromyography, mechanomyography, oculometrics, and spinal posture to promote either muscle relaxation, muscle activation or change in posture. Strength training has been performed mostly using basic exercise equipment according to various progression principles. These two types of interventions would thus result in increased ability to cope with physical workload or improved individual resources. In this narrative review, we analyzed the design, methods, and results of the retrieved studies on neck-shoulder sensory-motor responses among visual display unit users. A few studies have reported both an immediate decrease in neck-shoulder pain and an improvement after the end of the intervention following biofeedback, often based on surface electromyography, and strength training interventions targeting the shoulder girdle. Biofeedback and strength training interventions can respectively modify ability to cope with physical workload and individual resources resulting in increased physical capacity among visual display unit users. The long-term effects and the applicability of these approaches remain to be demonstrated at workplace settings. Future studies could combine both modalities to increase versatility of the interventions.
为治疗视觉显示设备使用者的颈肩疼痛,已经开展了工作场所生物反馈和力量训练干预。生物反馈疗法利用表面肌电图、机械肌电图、眼球测量学和脊柱姿势来促进肌肉放松、肌肉激活或姿势改变。力量训练主要是根据不同的进展原则,使用基本的锻炼设备进行。因此,这两类干预措施将提高应对体力工作负荷的能力或改善个人资源。在这篇叙述性综述中,我们分析了检索到的有关视觉显示装置使用者颈肩感觉运动反应的研究的设计、方法和结果。有几项研究报告称,通过生物反馈(通常基于表面肌电图)和针对肩部的力量训练干预后,颈肩疼痛立即减轻,并在干预结束后有所改善。生物反馈和力量训练干预可分别改变应对体力工作量的能力和个人资源,从而提高视觉显示设备使用者的体能。这些方法的长期效果和适用性还有待在工作场所进行验证。未来的研究可以将这两种方式结合起来,以提高干预措施的通用性。
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引用次数: 0
Less Pain, but no changes in maximal inclination angles during an overhead reach task following local anesthetic in patients with ongoing shoulder pain 局部麻醉后,持续肩痛患者在高空伸手任务中的疼痛减轻,但最大倾斜角度没有变化
IF 2 4区 医学 Q3 NEUROSCIENCES Pub Date : 2024-09-08 DOI: 10.1016/j.jelekin.2024.102932
N.E. D’hondt , A.J.R. Leenen , H. Kiers , M.J.M. Hoozemans , T.D. Alta , M.P.J. van den Bekerom , M.P.J. van de Borne , M.P.J. van der List , H.E.J. Veeger

This multicenter observational study aimed to assess how pain reduction, induced by local anesthesia, affects the relative angular contributions of the shoulder girdle and trunk to the maximal angular performance during a semi-constrained overhead reach task in patients with ongoing shoulder pain. Twenty-nine individuals (age 59.0 SD 12.8 years;16-male) with symptomatic shoulders were administered corticosteroid and lidocaine injections by their attending orthopedic surgeon. Immediately before and after the injections, participants reached for a target on the ceiling ten times as high as possible while their pain levels, shoulder, and trunk movements were recorded. The analysis revealed that there was a significant reduction in pain following the injections. However, there were no significant differences in maximum shoulder and trunk inclination angles between the pre- and post-injection conditions. Notably, there were slight but statistically significant alterations in humeroscapular kinematics during the initial phase of arm elevation following the injections. In conclusion, acute pain relief following local anesthetics is not associated with immediate alterations in maximum shoulder girdle and trunk inclination angles during a semi-constrained overhead reach task in patients with ongoing shoulder pain. However, there are signs of small alterations in humeroscapular kinematics during the initial phase of arm elevation.

这项多中心观察性研究旨在评估局部麻醉引起的疼痛减轻如何影响肩痛患者在半受限高空伸展任务中肩部和躯干对最大角度表现的相对角度贡献。29 名肩部有症状的患者(年龄 59.0 SD 12.8 岁;16 名男性)接受了骨科主治医生提供的皮质类固醇和利多卡因注射。注射前后,受试者向天花板上的目标伸手,尽可能高十倍,同时记录他们的疼痛程度、肩部和躯干动作。分析结果显示,注射后疼痛明显减轻。然而,注射前和注射后,肩部和躯干的最大倾斜角度没有明显差异。值得注意的是,在注射后手臂抬高的初始阶段,肱骨胛骨运动学发生了轻微的变化,但在统计学上具有显著意义。总之,局部麻醉后的急性疼痛缓解与持续肩痛患者在半受限高举任务中最大肩带和躯干倾斜角度的即时改变无关。不过,在手臂抬高的初始阶段,有迹象表明肱骨肩胛骨运动学发生了微小变化。
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引用次数: 0
Upper arm muscle activity is influenced by both forearm posture and wrist exertion direction during isometric wrist flexion and extension 在手腕等长屈伸过程中,上臂肌肉活动受前臂姿势和手腕用力方向的影响。
IF 2 4区 医学 Q3 NEUROSCIENCES Pub Date : 2024-08-30 DOI: 10.1016/j.jelekin.2024.102919
Lea Gerditschke, Jeff S. Schrattner, Davis A. Forman

The purpose of this study was to determine how wrist exertion direction and forearm posture independently influence upper arm muscle activity during isometric wrist contractions. Surface electromyography was recorded from three muscles of the upper-limb: biceps brachii, triceps brachii, and brachioradialis. Participants were seated with their forearm supported in one of three postures (supinated/neutral/pronated) with an adjustable force transducer that could be placed either above, below, or to the right/left of the participant’s hand. Participants performed randomized trials of isometric wrist flexion or extension at five relative intensities: 20, 40, 60, 80, or 100% of maximal force. Trials lasted 4.5 s and both wrist force and electromyography data were assessed. In general, the elbow flexors were more active during wrist flexion, while the triceps were more active in wrist extension, but this pattern reversed in certain forearm postures and wrist exertion directions. Both forearm posture and wrist exertion direction resulted in unique effects on upper arm muscle activity. These findings suggest that muscle activity of the upper arm muscles is influenced independently by both posture and force direction, which should be carefully considered by both motor control specialists and ergonomists.

本研究旨在确定手腕用力方向和前臂姿势如何在手腕等长收缩时独立影响上臂肌肉活动。对上肢的三块肌肉:肱二头肌、肱三头肌和肱四头肌进行了表面肌电图记录。受试者坐着,前臂以三种姿势(上举/中性/下垂)之一支撑,可调节的力传感器可放置在受试者手的上方、下方或右侧/左侧。受试者以 20、40、60、80 或 100%(最大力量的 20、40、60、80 或 100%)五种相对强度随机进行腕关节屈伸等长试验。试验持续 4.5 秒,并对腕力和肌电图数据进行评估。一般来说,腕关节屈曲时肘屈肌更活跃,而腕关节伸展时肱三头肌更活跃,但在某些前臂姿势和腕关节用力方向上,这种模式会发生逆转。前臂姿势和手腕用力方向都会对上臂肌肉活动产生独特的影响。这些研究结果表明,上臂肌肉的活动受姿势和用力方向的独立影响,运动控制专家和人体工程学专家都应仔细考虑这一点。
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引用次数: 0
Altered muscle fibre activation in an antagonistic muscle pair due to perturbed afferent feedback caused by blood flow restriction 血流受限引起的传入反馈紊乱导致一对拮抗肌的肌纤维激活发生变化。
IF 2 4区 医学 Q3 NEUROSCIENCES Pub Date : 2024-08-27 DOI: 10.1016/j.jelekin.2024.102922
Franziska Bubeck , André Tomalka , Tobias Siebert , Oliver Röhrle , Leonardo Gizzi

Purpose

This study aimed to better understand the coping strategy of the neuromuscular system under perturbed afferent feedback. To this end, the neuromechanical effects of transient blood flow restriction (BFR) compared to atmospheric pressure were investigated in an antagonistic muscle pair.

Methods

Perceived discomfort and neuromechanical parameters (torque and high-density electromyography) were recorded during submaximal isometric ankle dorsiflexion before, during and after BFR. The tibialis anterior and gastrocnemius lateralis muscles were studied in 14 healthy young adults.

Results

Discomfort increased during BFR and decreased to baseline level afterwards. The exerted torque and the co-activation index remained constant, whereas the EMG signal energy increased significantly during BFR. Coherence analysis of the delta band remained constant, whereas the alpha band shows an increase during BFR. Median frequency and muscle fibre conduction velocity showed a positive trend during the first minutes of BFR before significantly decreasing. Both parameters exceeded baseline values after cuff deflation.

Conclusion

Perturbed afferent feedback leads to altered neuromechanical parameters. We assume that increased central drive is required to maintain force output, resulting in changed muscle fibre activity. Glycolytic fast-switch fibres are only active for a short time due to oxygen deprivation and hyperacidity, but fatigue effects predominate in the long term.

目的:本研究旨在更好地了解神经肌肉系统在扰动传入反馈下的应对策略。为此,研究了瞬时血流限制(BFR)与大气压力相比对拮抗肌对神经机械的影响:方法:在 BFR 之前、期间和之后的亚极限等长踝关节外翻过程中,记录感觉到的不适和神经机械参数(扭矩和高密度肌电图)。对 14 名健康的年轻人的胫骨前肌和腓肠肌进行了研究:结果:在踝关节外展时,不适感增加,之后则降至基线水平。施加的扭矩和共同激活指数保持不变,而肌电图信号能量在 BFR 期间显著增加。德尔塔波段的相干性分析保持不变,而阿尔法波段在 BFR 期间有所增加。中位频率和肌纤维传导速度在 BFR 的最初几分钟内呈正趋势,随后明显下降。袖带放气后,这两个参数都超过了基线值:结论:紊乱的传入反馈会导致神经机械参数的改变。我们假定需要增加中枢驱动力来维持力输出,从而导致肌纤维活动发生变化。由于缺氧和胃酸过多,糖酵解快速开关纤维只在短时间内活跃,但疲劳效应在长期内占主导地位。
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引用次数: 0
Relation between stretch and activation of the medial gastrocnemius muscle during gait in children with cerebral palsy compared to typically developing children 与发育正常的儿童相比,脑瘫儿童在步态过程中内侧腓肠肌的伸展和激活之间的关系
IF 2 4区 医学 Q3 NEUROSCIENCES Pub Date : 2024-08-26 DOI: 10.1016/j.jelekin.2024.102921
Eline Flux , Babette Mooijekind , Lynn Bar-On , Edwin H.F. van Asseldonk , Annemieke I. Buizer , Marjolein M. van der Krogt

Stretch hyperreflexia is often a target for treatment to improve gait in children with spastic cerebral palsy (CP). However, the presence of stretch hyperreflexia during gait remains debated. Therefore, we assessed the relation between gastrocnemius medialis muscle-tendon stretch and muscle activation during gait in children with CP compared to typically developing (TD) children. 3D gait analysis including electromyography (EMG) and dynamic ultrasound was carried out to assess, respectively gastrocnemius medialis activation and fascicle, belly, and tendon stretch during treadmill walking. Musculotendon-unit stretch was also estimated using OpenSim. Ratios of EMG/peak lengthening velocities and accelerations were compared between CP and TD. Velocity and acceleration peaks prior to EMG peaks were qualitatively assessed. EMG/velocity and EMG/acceleration ratios were up to 500% higher for CP (n = 14) than TD (n = 15) for most structures. Increased late swing muscle activation in CP was often preceded by fascicle and musculotendon-unit peak lengthening velocity, and early stance muscle activation by peaks in multiple structures. Increased muscle activation in CP is associated with muscle-tendon stretch during gait. Concluding, late swing muscle activation in CP appears velocity-dependent, whereas early stance activation can be velocity- and acceleration-dependent. These insights into stretch reflex mechanisms during gait can assist development of targeted interventions.

伸展反射亢进通常是痉挛性脑瘫(CP)患儿改善步态的治疗目标。然而,步态过程中是否存在伸展反射亢进仍存在争议。因此,我们评估了与发育正常(TD)儿童相比,CP 儿童步态过程中腓肠肌内侧肌肉-肌腱伸展与肌肉激活之间的关系。我们进行了三维步态分析,包括肌电图(EMG)和动态超声波,以分别评估跑步机行走过程中腓肠肌内侧的激活和筋膜、筋腹和肌腱的伸展。此外,还使用 OpenSim 对肌肉肌腱单位的拉伸进行了估算。CP 和 TD 的肌电图/拉伸速度和加速度峰值比率进行了比较。对肌电图峰值之前的速度和加速度峰值进行了定性评估。就大多数结构而言,CP(n = 14)的肌电图/速度和肌电图/加速度比率比 TD(n = 15)高出多达 500%。在 CP 中,挥杆晚期肌肉激活的增加往往先于筋膜和肌腱单位的峰值拉长速度,而站立早期肌肉激活的增加则先于多个结构的峰值拉长速度。CP 肌肉激活的增加与步态过程中肌肉肌腱的伸展有关。总之,CP 的晚期摆动肌肉激活似乎与速度有关,而早期站立肌肉激活可能与速度和加速度有关。这些对步态过程中拉伸反射机制的见解有助于制定有针对性的干预措施。
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Journal of Electromyography and Kinesiology
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