中国组织工程研究

中国组织工程研究 ›› 2025, Vol. 29 ›› Issue (14): 2899-2906.doi: 10.12307/2025.617

• 肌肉肌腱韧带组织构建 tissue construction of the muscle, tendon and ligament • 上一篇    下一篇

前交叉韧带重建患者步行时患侧腿部肌肉协同特征与步态稳定性的相关性

魏梦力1，2，钟亚平1，2，于婷婷1，谭茜琳1，曹偲佳1   

  1. 1武汉体育学院体育大数据研究中心，湖北省武汉市  430079；2湖北省运动与健康创新发展研究中心，湖北省武汉市  430079

  • 收稿日期:2024-05-13 接受日期:2024-07-06 出版日期:2025-05-18 发布日期:2024-09-27
  • 通讯作者: 钟亚平，博士，教授，博士生导师，武汉体育学院体育大数据研究中心，湖北省武汉市 430079；湖北省运动与健康创新发展研究中心，湖北省武汉市 430079
  • 作者简介:魏梦力，男，1995年生，湖北省襄阳市人，汉族，武汉体育学院在读博士，主要从事运动控制理论与实践相关研究。
  • 基金资助:
    国家社科基金后期资助重点项目(22FTYA001)，项目负责人：钟亚平；国家体育总局决策咨询研究项目(2023-B-19)，项目负责人：钟亚平；湖北省高等学校省级教学研究项目(2022395)，项目负责人：钟亚平

Correlation between muscle synergy characteristics of the affected leg and gait stability during walking in patients undergoing anterior cruciate ligament reconstruction

Wei Mengli1, 2, Zhong Yaping1, 2, Yu Tingting1, Tan Xilin1, Cao Sijia1   

  1. 1Sports Big Data Research Center of Wuhan Sports University, Wuhan 430079, Hubei Province, China; 2Hubei Sports and Health Innovation and Development Research Center, Wuhan 430079, Hubei Province, China
  • Received:2024-05-13 Accepted:2024-07-06 Online:2025-05-18 Published:2024-09-27
  • Contact: Zhong Yaping, PhD, Professor, Doctoral supervisor, Sports Big Data Research Center of Wuhan Sports University, Wuhan 430079, Hubei Province, China;Hubei Sports and Health Innovation and Development Research Center, Wuhan 430079, Hubei Province, China
  • About author:Wei Mengli, PhD candidate, Sports Big Data Research Center of Wuhan Sports University, Wuhan 430079, Hubei Province, China; Hubei Sports and Health Innovation and Development Research Center, Wuhan 430079, Hubei Province, China
  • Supported by:
    Late-stage Key Project of the National Social Science Foundation of China, No. 22FTYA001 (to ZYP); Decision-making Consultation Research Project of General Administration of Sport of China, No. 2023-B-19 (to ZYP); Hubei Provincial Higher Education Reform Project, No. 2022395 (to ZYP)

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摘要：




文题释义：
肌肉协同理论：被广泛用于解释人体肌肉协同过程，该理论认为人体动作的实现是中枢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，使肌肉产生协同收缩的过程。
前交叉韧带：是稳定膝关节的重要结构，在膝部各韧带中最易受损。前交叉韧带断裂后，膝关节的不稳不但会影响人们的日常活动和运动，而且会造成关节内结构的进一步损伤。

背景：现有研究初步总结了前交叉韧带重建患者步行时患侧腿肌肉活动与步态稳定性的潜在关联，然而存在观测肌肉类别不全、观测步行动作阶段不完整、未考量多块肌肉间协同作用等问题，亟待进一步完善该研究。
目的：监测前交叉韧带重建患者步行时患侧腿部肌肉协同信息，分析肌肉协同信息与步态稳定性的关联。
方法：招募24例男性前交叉韧带重建患者，年龄(21.66±4.09)岁，采集受试者步行时患肢的肌电数据与压力中心数据，采用非负矩阵分解算法提取患肢的肌肉协同元参与数量、肌肉协同元峰值激活用时及肌肉相对权重指标，并与压力中心指标进行相关性分析。
结果与结论：①累计解析出6类肌肉协同元参与步行活动，其中肌肉协同元参与数量与患者步态压力中心横向位移距离、横向位移速度无显著相关性。在肌肉协同元峰值激活用时方面，主导步态承重反应期的协同元3峰值激活用时与患者步态压力中心横向位移距离、横向位移速度均呈显著负相关(r=-0.413，P=0.045；r=-0.470，P=0.020)，其余类型协同元的峰值激活用时与患者步态稳定性指标无显著相关性。在肌肉相对权重方面，主导步态承重反应期的协同元1的股直肌与患者步态压力中心横向位移距离、横向位移速度均呈显著负相关(r=-0.592，P=0.005；r=-0.529，P=0.014)；主导承重反应期的协同元3的股二头肌的相对权重与患者步态压力中心横向位移距离呈显著负相关(r=-0.428，P=0.037)。②结果表明，前交叉韧带重建患者的中枢系统会系统调节步行时患肢肌肉协同活动以提升步态稳定性，具体表现为：延长主导承重反应期肌肉协同元激活时间，增强股四头肌的激活程度，以增强患侧腿落地时膝关节离心收缩控制能力，提升膝关节稳定性；增强承重反应期股二头肌激活程度，以增加患侧腿落地时膝关节屈曲程度，增强下肢落地缓冲功能。
https://orcid.org/0000-0001-8451-185X(魏梦力)；https://orcid.org/0000-0002-3010-5001(钟亚平)

关键词: 前交叉韧带重建, 步态分析, 步态稳定性, 肌肉协同模式, 非负矩阵分解, 压力中心

Abstract: BACKGROUND: Existing studies have preliminarily summarized the potential association between muscle activity of the affected lower limb and gait stability during walking in patients undergoing anterior cruciate ligament reconstruction. However, there are some issues such as incomplete observation of muscle categories, incomplete observation of walking action phases, and failure to consider synergistic effects among multiple muscle groups, which urgently require further improvement in this study.
OBJECTIVE: To monitor muscle synergy information of the affected leg during walking in patients undergoing anterior cruciate ligament reconstruction and to analyze the association between muscle synergy information and gait stability. 
METHODS: Twenty-four male patients aged (21.66±4.09) years undergoing anterior cruciate ligament reconstruction, were recruited. Electromyographic and center of pressure data were collected from the affected lower limb during walking. A non-negative matrix decomposition algorithm was used to extract the number of muscle synergic elements from the affected leg, the time spent in peak activation of each muscle synergic element, and the muscle relative weight indexes. Correlation analysis was then performed with the center of pressure indexes.
RESULTS AND CONCLUSION: Six types of muscle synergies were identified in the affected leg. The number of muscle synergic elements showed no significant correlation with the distance and speed of lateral displacement of the center of pressure. Regarding the peak activation time of muscle synergic elements, synergic element 3 in the dominant gait loading response period showed a significant negative correlation with the lateral displacement distance of the center of pressure (r=-0.413, P=0.045) and a significant negative correlation with the lateral displacement velocity of the center of pressure (r=-0.470, 
P=0.020). The activation time of the remaining types of muscle synergic elements was not significantly related with patient’s gait stability indices. In terms of muscle relative weights, the rectus femoris muscle of synergistic element 1 in the dominant gait loading response period showed a significant negative correlation with the lateral displacement distance of the center of pressure (r=-0.592, P=0.005) and a significant negative correlation with the lateral displacement speed of the center of pressure (r=-0.529, P=0.014). Additionally, the relative weight of the biceps femoris muscle of synergistic element 3 in the dominant gait loading response period showed a significant negative correlation with the lateral displacement distance of the center of pressure 
(r=-0.428, P=0.037). To conclude, the central system in patients undergoing anterior cruciate ligament reconstruction regulates the synergistic muscle activity of the affected leg during walking to enhance gait stability in two primary ways: by prolonging the activation time of the muscle synergists during the dominant loading response period and enhancing the activation of the quadriceps muscle, in order to enhance the control of eccentric contractions of the knee joint during the landing of the affected leg and improve the stability of the knee joint; and by increasing the activation of the biceps femoris muscle during the loading response period, which increases the degree of knee flexion and enhances the lower limb's cushioning function during the landing of the affected leg.

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

Key words: anterior cruciate ligament reconstruction, gait analysis, gait stability, muscle synergy patterns, non-negative matrix decomposition, center of pressure

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