中国组织工程研究

中国组织工程研究 ›› 2026, Vol. 30 ›› Issue (33): 8653-8661.doi: 10.12307/2026.494

• 脊柱组织构建 spinal tissue construction • 上一篇    下一篇

Lenke5型青少年特发性脊柱侧凸患者步行运动学与肌电特征

刘家齐1，周  鼎2，姜雅文2，倪思敏3，李  宁1，朱志涛2，刘  玥1，陈清华2，梅  钊4，姚怡飞5，王金武6   

  1. 1山东第二医科大学康复医学院，山东省潍坊市   261053；2上海体育大学运动健康学院，上海市   200438；3英国伦敦大学学院，英国伦敦   WC1E 6BT；4华柱医疗科技有限公司，上海市   201204；5上海交通大学生物医学工程学院，上海市   200030；6上海市骨科内植物重点实验室，上海交通大学医学院附属第九人民医院骨科，上海市   200011
  • 收稿日期:2026-03-05 修回日期:2026-03-23 出版日期:2026-11-28 发布日期:2026-06-10
  • 通讯作者: 第一作者：刘家齐，女，1998年生，山东省潍坊市人，汉族，硕士，主要从事脊柱侧凸相关康复方面的研究。 并列第一作者：周鼎，女，1996年生，上海市人，汉族，硕士，主要从事足踝、脊柱侧凸康复方面的研究。
  • 作者简介:王金武，博士，教授，主任医师，上海市骨科内植物重点实验室，上海交通大学医学院附属第九人民医院骨科，上海市 200011
  • 基金资助:
    上海交通大学医学院附属第九人民医院临床研究型MDT项目(201914)，项目负责人：王金武；贵州省科技支撑计划(黔科合支撑[2023]一般 196)，项目参与人：王金武

Gait kinematics and electromyography features in patients with Lenke type 5 adolescent idiopathic scoliosis

Liu Jiaqi1, Zhou Ding2, Jiang Yawen2, Ni Simin3, Li Ning1, Zhu Zhitao2, Liu Yue1, Chen Qinghua2, Mei Zhao4, Yao Yifei5, Wang Jinwu6    

  1. 1Rehabilitation School, Shandong Second Medical University, Weifang 261053, Shandong Province, China; 2School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China; 3University College London, London WC1E 6BT, UK; 4Huazhu Medical Technology Co., Ltd. (Shanghai), Shanghai 201204, China; 5School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200030, China; 6Shanghai Key Laboratory of Orthopedics, Department of Orthopedic Surgery, Shanghai Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
  • Received:2026-03-05 Revised:2026-03-23 Online:2026-11-28 Published:2026-06-10
  • Contact: Wang Jinwu, MD, Professor, Chief physician, Shanghai Key Laboratory of Orthopedics, Department of Orthopedic Surgery, Shanghai Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
  • About author:Liu Jiaqi, MS, Rehabilitation School, Shandong Second Medical University, Weifang 261053, Shandong Province, China Zhou Ding, MS, School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China Liu Jiaqi and Zhou Ding contributed equally to this work.
  • Supported by:
    Clinical Research-Oriented MDT Project, Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 201914 (to WJW); Guizhou Provincial Science and Technology Support Program, No. [2023] General 196 (to WJW [project participant]) 

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摘要：



文题释义：
Lenke5型青少年特发性脊柱侧凸：Lenke分型是根据脊柱弯曲的数量和位置，将脊柱侧凸进行分类的一种方法，用于帮助临床医生识别脊柱侧凸曲线类型并指导治疗。Lenke5型是指胸腰椎或腰椎曲线为主要且唯一的结构弯曲，常合并骨盆旋转。
步态分析：是对人体行走模式进行系统性、量化评估的一种方法，旨在描述并解释步行过程中的时空特征、关节运动学及神经肌肉控制模式。

背景：Lenke5型青少年特发性脊柱侧凸的静态影像学参数提示腰椎畸形会影响骨盆的相对位置，但步行过程中躯干-骨盆-下肢的节段活动特征以及核心肌群的代偿控制缺乏定量研究。
目的：评估Lenke5型青少年特发性脊柱侧凸患者在步行过程中的运动学特征。
方法：纳入Cobb角20°-36°、年龄10-15岁的Lenke5型青少年特发性脊柱侧凸患者以及同年龄段健康青少年各20例，在匀速步行条件下同步采集并分析两组受试者的步行时空参数、运动学参数以及肌电的差异。
结果与结论：①步态参数：Lenke5型青少年特发性脊柱侧凸患者的步宽、凸侧双支撑相占比、凹侧摆动相占比显著大于健康对照组(P < 0.05)；其中凸侧支撑相占比、双支撑相占比大于凹侧(P < 0.05)；凸侧步长、摆动相占比小于凹侧(P < 0.05)；②运动学参数：Lenke5型青少年特发性脊柱侧凸患者的腰段脊柱和脊柱-骨盆相对活动在冠状面上的活动范围均显著大于健康对照组(P < 0.05)；凸侧髋关节屈曲峰值角度和踝关节跖屈峰值角度均显著小于健康对照组，且凹侧大于凸侧(P < 0.05)；③表面肌电结果：Lenke5型青少年特发性脊柱侧凸患者的双侧竖脊肌、双侧臀中肌、凸侧腹外斜肌和凸侧臀大肌的肌电信号显著大于健康对照组(P < 0.05)，其中凸侧竖脊肌、腹外斜肌显著大于凹侧，而凸侧臀中肌显著小于凹侧(P < 0.05)；④上述结果提示：在步行过程中，Lenke5型青少年特发性脊柱侧凸患者凸侧下肢作为主要支撑，凹侧下肢通过髋关节和踝关节增大活动度做更多代偿进行下肢摆动，躯干通过增大冠状面的活动范围来平衡下肢运动的不对称，维持步行稳定。凸侧竖脊肌与腹外斜肌共同增强以维持躯干稳定，凹侧臀中肌进行代偿性募集，这表示Lenke5型青少年特发性脊柱侧凸患者在关节活动的基础上通过双侧失衡的肌肉控制策略以维持身体平衡和稳定。
https://orcid.org/0009-0009-4358-015X (刘家齐) 


中国组织工程研究杂志出版内容重点：干细胞；骨髓干细胞；造血干细胞；脂肪干细胞；肿瘤干细胞；胚胎干细胞；脐带脐血干细胞；干细胞诱导；干细胞分化；组织工程

关键词: 青少年特发性脊柱侧凸, Lenke5型, 步态分析, 运动学, 表面肌电, 脊柱, 骨盆, 腰椎

Abstract: BACKGROUND: Static imaging parameters in adolescents with Lenke type 5 adolescent idiopathic scoliosis suggest that lumbar deformity may alter relative pelvic alignment. However, quantitative evidence on segmental kinematics of the trunk–pelvis–lower limb complex during walking and on compensatory control by core musculature remains limited.
OBJECTIVE: To evaluate the kinematic characteristics during walking in patients with Lenke type 5 adolescent idiopathic scoliosis.
METHODS: Twenty patients with Lenke type 5 adolescent idiopathic scoliosis (Cobb angle 20°-36°, age 10-15 years) and 20 age-matched healthy adolescents were enrolled. Spatiotemporal gait parameters, kinematic parameters, and electromyographic differences during walking at a constant speed were simultaneously collected and analyzed between the two groups. 
RESULTS AND CONCLUSION: (1) Gait parameters: Step width, the percentage of convex-side double-support phase, and percentage of concave-side swing phase over the gait cycle were significantly greater in the Lenke type 5 adolescent idiopathic scoliosis group compared with the healthy control group (P < 0.05). The percentages of convex-side stance phase and double-support phase were significantly greater than those on the concave side (P < 0.05), while convex-side step length and swing phase percentage were significantly smaller than those on the concave side (P < 0.05). (2) Kinematic parameters: The range of motion in the coronal plane for the lumbar spine and spine-pelvis relative movement was significantly greater in the Lenke type 5 adolescent idiopathic scoliosis group than the healthy control group (P < 0.05). Convex-side peak hip flexion angle and peak ankle plantarflexion angle were significantly smaller than those in the healthy control group, and these angles were greater on the concave side than on the convex side (P < 0.05). (3) Surface electromyography results: Electromyographic signals of the bilateral erector spinae, bilateral gluteus medius, convex-side external oblique, and convex-side gluteus maximus were significantly greater in the Lenke type 5 adolescent idiopathic scoliosis group compared with the healthy control group (P < 0.05). Signals from the convex-side erector spinae and external oblique were significantly greater than those on the concave side, while convex-side gluteus medius signals were significantly smaller than those on the concave side (P < 0.05). (4) Overall, these findings suggest that during walking, in patients with Lenke type 5 adolescent idiopathic scoliosis, the convex-side lower limb serves as the primary support. The concave-side lower limb compensates during the swing phase by increasing range of motion at the hip and ankle joints. Increased coronal-plane trunk mobility helps maintain gait stability. Convex-side erector spinae–external oblique co-activation and concave-side gluteus medius recruitment indicate side-specific neuromuscular compensation to maintain balance. This indicates that adolescents with Lenke Type 5 idiopathic scoliosis maintain body balance and stability through bilateral imbalanced muscle control strategies based on joint mobility.

Key words: adolescent idiopathic scoliosis, Lenke type 5, gait analysis, kinematics, surface electromyography, spine, pelvis, lumbar spine

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