从肌电图数据看普通整骨疗法对肌肉张力的影响

N. V. Cherednikova, V. F. Zhang, Y. Potekhina, D. .. Miroshnichenko
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引用次数: 0

摘要

导言。整骨疗法的临床研究因治疗缺乏标准化和没有充分使用工具方法来评估其有效性而受到批评。因此,为了增加整骨疗法的证据,有必要寻找能够记录和测量标准化整骨疗法矫正后客观指标及其变化的工具方法。 本研究的目的是利用肌电图研究普通整骨疗法对健康人肌肉张力的影响。 材料和方法。研究在梅契尼科夫西北水利水电大学整骨疗法系的基础上进行。30 名年龄在 20 至 42 岁(中位数为 25 岁)、无任何主动症状的健康志愿者参加了研究。不纳入研究的标准是:患有骨科治疗绝对禁忌症的疾病和/或病症、服用肌肉松弛剂或乙酰胆碱酯酶抑制剂、患有 ICD-10 中 G00-G83 组疾病、外伤史少于 1 年。所有志愿者都接受了普通整骨疗法(GOT),这是整骨疗法矫正的一种标准化变体。在进行 GOT 治疗前后,使用表面肌电图(sEMG)对肌肉张力进行了研究,该研究是在 "Kolibri"(生产商 LLC "Neurotech",俄罗斯)电生理信号无线监测系统上进行的。静止时,测量上臂、肩胛间区、大腿前后肌群和小腿肌肉电活动的平均振幅。多个肌群的记录是同时进行的,身体左右两侧的记录也是同步进行的。 结果。在 GOT 之后,大腿前表面肌肉电活动的平均振幅从中位数的 8 MV 降至 4 MV(p = 0,00001),小腿前表面肌肉电活动的平均振幅从中位数的 9 MV 降至 7 mv(p = 0,008),这表明它们已经放松。其他肌群的张力在统计学上没有明显变化。在研究的肌肉中观察到电活动平均振幅不对称,这表明对称肌肉之间的张力不平衡。在大多数研究的肌肉群中,这一指标在 GOT 后没有明显的统计学变化。只有在大腿前侧肌群中,电活动平均振幅的不对称性从中位数 7 MV 显著下降到 2 MV(p = 0,0046)。 结论在 sEMG 的帮助下,我们发现一个疗程的 GOT 可以降低大腿前侧肌群和小腿肌群的张力,并降低大腿前侧肌群张力的不对称性。这些结果可以从 GOT 通过改善肌肉组织本身和周围筋膜的特性,以及对神经系统的抑制和协调作用对骨骼肌产生影响的角度来解释,因为神经系统可以确保肌肉张力的维持和调节。表面肌电图可用于客观记录和测量整骨疗法的矫正结果,以增加整骨疗法临床试验的证据。
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The effect of general osteopathic treatment on muscle tone according to electromyography data
Introduction. Clinical research in osteopathy is criticized for the lack of standardization of treatment and insufficient use of instrumental methods to assess its effectiveness. Therefore, in order to increase evidence in osteopathy, it is relevant to search for instrumental methods that allow recording and measuring objective indicators and their changes after standardized osteopathic correction.   The aim of the study is to research the effect of general osteopathic treatment on muscle tone using electromyography in practically healthy people.   Materials and methods. A study was conducted on the basis of the Department of Osteopathy of the Mechnikov NWSMU. 30 practically healthy volunteers without any active complaints, aged 20 to 42 years (median 25 years), took part in the study. The criteria for non-inclusion were the presence of diseases and/or conditions that are an absolute contraindication to osteopathic correction, taking muscle relaxants or acetylcholinesterase inhibitors, diseases belonging to the G00-G83 group according to ICD-10, the presence of a trauma history for less than 1 year. All volunteers underwent general osteopathic treatment (GOT) as a standardized variant of osteopathic correction. Before and immediately after the GOT, muscle tone was studied using surface electromyography (sEMG), which was performed on the complex of wireless monitoring of electrophysiological signals «Kolibri» (manufacturer LLC «Neurotech», Russia). At rest, the average amplitude of the electrical activity of the muscles of the upper arms, the interscapular region, the anterior and posterior muscle groups of the thigh and lower legwere measured. The recording was made simultaneously from several muscle groups, synchronously from the right and left sides of the body.   Results. After the GOT, a statistically significant decrease in the average amplitude of the thigh anterior surface muscles electrical activity from the median of 8 MV to 4 MV (p = 0,00001), the lower leg anterior surface from the median of 9 MV to 7 mv (p = 0,008) was detected, which indicates their relaxation. The tone of the other muscle groups did not change statistically significantly. The asymmetry of the average amplitude of electrical activity was observed in the studied muscles, which shows an imbalance of tone between symmetrical muscles. In most of the studied muscle groups, this indicator did not change statistically significantly after the GOT. And only in the anterior thigh muscle group, the asymmetry of the average amplitude of electrical activity decreased statistically significantly from the median of 7 MV to 2 MV (p = 0,0046).   Conclusion. With the help of the sEMG, it was found that one session of GOT leads to a decrease in the tone of the anterior thigh and lower leg muscle groups, as well as a decrease in the asymmetry of the tone of the anterior thigh muscle group. These results can be explained from the standpoint of the GOT effect on skeletal muscles by means of improving the characteristics of the muscle tissue itself and the surrounding fascia, as well as by inhibitory and harmonizing effects on the nervous system, which ensures the maintenance and regulation of muscle tone. Surface EMG can be used to objectively record and measure the results of osteopathic correction to increase the evidence of clinical trials in osteopathy.
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