中国组织工程研究

中国组织工程研究 ›› 2023, Vol. 27 ›› Issue (29): 4704-4711.doi: 10.12307/2023.658

• 骨科植入物相关临床实践 Clinical practice of orthopedic implant • 上一篇    下一篇

单侧膝关节屈曲受限下肢肌肉的协同特征

安义帅1，2，张峻霞1，2，李  慧1，2，张雨虓1，2，徐国良1，2，高  昆1，2，于淑晗1，2，刘泽龙1，2   

  1. 1天津科技大学机械工程学院，天津市   300222；2天津市轻工与食品工程机械装备集成设计与在线监控实验室，天津科技大学，天津市   300222
  • 收稿日期:2022-08-03 接受日期:2022-09-07 出版日期:2023-10-18 发布日期:2022-12-02
  • 通讯作者: 张峻霞，博士，教授，天津科技大学机械工程学院，天津市 300222；天津市轻工与食品工程机械装备集成设计与在线监控实验室，天津科技大学，天津市 300222
  • 作者简介:安义帅，男，1998年生，山东省临清市人，汉族，天津科技大学在读硕士，主要从事仿生健康与康复机械系统研究。
  • 基金资助:
    国家自然科学基金委员会面上项目(50975204)，项目负责人：张峻霞

Synergistic characteristics of lower extremity muscles with unilateral knee flexion limitation

An Yishuai1, 2, Zhang Junxia1, 2, Li Hui1, 2, Zhang Yuxiao1, 2, Xu Guoliang1, 2, Gao Kun1, 2, Yu Shuhan1, 2, Liu Zelong1, 2   

  1. 1School of Mechanical Engineering, Tianjin University of Science & Technology, Tianjin 300222, China; 2Tianjin Key Laboratory of Integrated Design and Online Monitoring for Light Industry and Food Engineering Machinery and Equipment, Tianjin University of Science & Technology, Tianjin 300222, China
  • Received:2022-08-03 Accepted:2022-09-07 Online:2023-10-18 Published:2022-12-02
  • Contact: Zhang Junxia, MD, Professor, School of Mechanical Engineering, Tianjin University of Science & Technology, Tianjin 300222, China; Tianjin Key Laboratory of Integrated Design and Online Monitoring for Light Industry and Food Engineering Machinery and Equipment, Tianjin University of Science & Technology, Tianjin 300222, China
  • About author:An Yishuai, Master candidate, School of Mechanical Engineering, Tianjin University of Science & Technology, Tianjin 300222, China; Tianjin Key Laboratory of Integrated Design and Online Monitoring for Light Industry and Food Engineering Machinery and Equipment, Tianjin University of Science & Technology, Tianjin 300222, China
  • Supported by:
    General Project of the National Natural Science Foundation of China, No. 50975204 (to ZJX)

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摘要：


文题释义：

肌肉协同：是指一组肌肉的协调活动，神经系统事先编码一组肌肉协同元并根据目标任务对其进行排列组合，使肌肉产生协调收缩，从而完成预期的动作。
表面肌电信号：是肌肉收缩过程中产生的一种电生理信号，是在体表无创检测肌肉活动的重要方法。将电极片放置在人体皮肤表面即可记录皮肤表面因肌肉收缩而产生的微弱的电位差，再通过肌电采集电路放大和转换形成可用作处理的表面肌电信号。

背景：膝关节活动受限是一种比较常见的损伤后表现特征，但是对于膝关节活动受限下的肌肉协同有待研究。
目的：研究单侧膝关节屈曲受限与正常运动下肢肌肉协同的异同。
方法：招募20名健康成年人(男性12名，女性8名)作为受试者，分别采集屈曲受限条件下与无屈曲受限条件下自然行走的下肢表面肌电信号。通过非负矩阵分解算法从受限侧(右腿)的10块肌肉的表面肌电信号中提取肌肉协同，利用单因素方差分析研究在不同条件行走的步态参数显著差异。
结果与结论：①屈曲受限条件下，受试者进行行走任务时肌肉协同数量减少，表现出不同的肌肉协调模式控制并且招募新的肌肉协同单元；随着协同模块的减少，内侧腓肠肌、外侧腓肠肌和比目鱼肌激活时间从支撑相向摆动相偏移的越明显；主要依靠股直肌、股内侧肌、股外侧肌和阔筋膜张肌进行代偿，使其在激活水平上表现的异常活跃，同时受限侧表现出划圈、提胯等动作，因此受限后主要以受限侧髋关节代偿；②屈曲受限条件下，受试者受限侧和非受限侧在步态参数(频率、步速、步态周期和支撑相占比)方面对比受限前均存在显著差异(P < 0.05)，同时非受限侧单腿支撑时间相较于受限前明显增大(P < 0.01)，受限侧支撑相占比和单腿支撑时间显著小于非受限侧(P < 0.01)；③因此，膝关节屈曲运动减弱可被认为是导致下肢肢体内协调受损的关键因素，研究结果对运动功能的定量分析以及人体下肢康复指导具有意义，并为了解运动功能受损背后的神经肌肉控制机制提供重要的见解。
https://orcid.org/0000-0002-2827-8982 (安义帅) 
中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

关键词: 膝关节, 屈曲受限, 肌肉协同, 表面肌电, 非负矩阵分解

Abstract: BACKGROUND: Limitation of knee motion is a relatively common post-injury feature, but it remains to be understood how muscle synergy under knee motion limitation is affected.  
OBJECTIVE: To study the similarities and differences between unilateral knee flexion limitation and normal exercise lower extremity muscle synergy.
METHODS: Twenty healthy adults (12 males and 8 females) were recruited as subjects, and the surface electromyogram signals of the lower limbs in natural walking with or without flexion limitation were collected. Muscle synergy was extracted from the surface electromyogram signals of 10 muscles on the restricted side (right leg) by a non-negative matrix factorization algorithm, and one-way analysis of variance was used to study the significant differences in gait parameters of walking in different conditions.  
RESULTS AND CONCLUSION: (1) Under flexion limitation, the number of muscle synergies decreased during the walking task after restraint, showing different muscle coordination mode control and recruiting new muscle synergy units. With the decrease of the synergistic module, the activation time of the medial gastrocnemius, lateral gastrocnemius and soleus muscle shifted more obviously from the support phase to the swing phase. After the restriction, it mainly relied on the rectus femoris, vastus medialis, vastus lateralis and tensor fascia lata for compensation, making it abnormally active at the activation level, and at the same time, the restricted side showed movements such as circles and crotches, so after the restriction, the hip joint on the restricted side was mainly used as compensation. (2) Under flexion limitation, there were significant differences in gait parameters (frequency, pace, gait cycle, and support ratio) between the restricted side and the non-restricted side compared with those before restriction (P < 0.05). The single-leg support time was significantly increased (P < 0.01) compared to before the restriction. The proportion of support and the time of single-leg support on the restricted side were significantly smaller than those on the non-restricted side (P < 0.01). (3) Therefore, the weakening of knee flexion movement can be considered as a key factor leading to the impaired coordination of lower extremities. The results of the study have implications for the quantitative analysis of motor function and the guidance of human lower extremity rehabilitation, and provide important insights for understanding the neuromuscular control behind motor function impairment mechanism.

Key words: knee joint, flexion limitation, muscle synergy, surface electromyography, non-negative matrix factorization

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