腰背肌筋膜痛综合征核心肌群的表面肌电信号与肌纤维类型的相关性分析
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作者Author单位AddressE-Mail
姜美驰 JIANG Mei-chi 中国中医科学院西苑医院康复理疗科, 北京 100091 Department of Rehabilitation Physical Therapy, Xiyuan Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing 100091, China  
肖京 XIAO Jing 中国中医科学院西苑医院康复理疗科, 北京 100091 Department of Rehabilitation Physical Therapy, Xiyuan Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing 100091, China 58280244@sina.com 
饶毅 RAO Yi 中国中医科学院西苑医院康复理疗科, 北京 100091 Department of Rehabilitation Physical Therapy, Xiyuan Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing 100091, China  
赵兴丽 ZHAO Xing-li 中国中医科学院西苑医院康复理疗科, 北京 100091 Department of Rehabilitation Physical Therapy, Xiyuan Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing 100091, China  
曹昺焱 CAO Bing-yan 中国中医科学院西苑医院康复理疗科, 北京 100091 Department of Rehabilitation Physical Therapy, Xiyuan Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing 100091, China  
庄威 ZHUANG Wei 中国中医科学院西苑医院康复理疗科, 北京 100091 Department of Rehabilitation Physical Therapy, Xiyuan Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing 100091, China  
期刊信息:《中国骨伤》2019年,第32卷,第6期,第544-548页
DOI:10.3969/j.issn.1003-0034.2019.06.012
基金项目:中国中医科学院自主选题项目资助(编号:ZZ070857)
中文摘要:

目的:运用表面肌电检测腰背肌筋膜痛患者腰部核心肌群,通过中位频率及中位频率斜率的分析,判断其肌纤维类型分布规律。

方法:2017年10月至2018年3月100例腰背肌筋膜炎患者,男45例,女55例;年龄29~76岁,平均48.5岁;左侧腰背疼痛(左侧疼痛组)40例,右侧腰背疼痛(右侧疼痛组)60例;病程>6个月。另有40例腰部无疼痛健康人为对照组,男20例,女20例;年龄29~76岁,平均47.3岁。患者均有不同程度的背部酸痛及背部肌肉僵硬,经临床和影像学检查诊断为腰背肌筋膜炎。使用表面肌电测量3组人群的腰部核心肌肉(多裂肌、髂肋肌、最长肌)在腰背肌等长收缩试验过程中的肌电信号特征,如中位频率及中位频率斜率绝对值。

结果:3组多裂肌的中位频率,对照组左侧(133.88±26.61)μV,右侧(131.39±29.81)μV;左侧疼痛组左侧(117.29±10.93)μV,右侧(133.70±17.81)μV;右侧疼痛组左侧(131.36±17.37)μV,右侧(118.28±13.57)μV。3组髂肋肌的中位频率,对照组左侧(106.94±28.01)μV,右侧(114.68±18.96)μV;左侧疼痛组左侧(93.95±11.17)μV,右侧(107.60±27.86)μV;右侧疼痛组左侧(105.93±15.52)μV,右侧(97.27±19.27)μV。3组最长肌的中位频率,对照组左侧(109.24±26.20)μV,右侧(112.58±17.70)μV;左侧疼痛组左侧(95.58±10.83)μV,右侧(108.79±26.39)μV;右侧疼痛组左侧(106.50±17.98)μV,右侧(98.20±11.16)μV。3组多裂肌的中位频率斜率绝对值,对照组左侧0.221±0.109,右侧0.259±0.169;左侧疼痛组左侧0.318±0.184,右侧0.210±0.159;右侧疼痛组左侧0.258±0.169,右侧0.386±0.166。3组髂肋肌的中位频率斜率绝对值,对照组左侧0.241±0.158,右侧0.238±0.128;左侧疼痛组左侧0.330±0.208,右侧0.252±0.171;右侧疼痛组左侧0.249±0.150,右侧0.343±0.144。3组最长肌的中位频率斜率绝对值,对照组左侧0.244±0.252,右侧0.210±0.128;左侧疼痛组左侧0.348±0.255,右侧0.241±0.224;右侧疼痛组左侧0.239±0.155,右侧0.334±0.233。对照组左右侧腰多裂肌、髂肋肌、最长肌的中位频率和中位频率斜率绝对值差异无统计学意义(P>0.05);腰痛组疼痛侧多裂肌、髂肋肌、最长肌的中位频率值小于非疼痛侧(P<0.05),中位频率斜率绝对值大于非疼痛侧(P<0.05)。

结论:慢性腰背筋膜痛患者疼痛侧的腰部肌肉耐疲劳程度下降,肌纤维类型百分比转变为以Ⅱ型肌纤维为主。
【关键词】腰痛  肌筋膜疼痛综合征  肌电描记术  肌纤维  骨骼
 
Correlation analysis between the surface electromyography and muscle fiber types of the core muscle group in the patients with myofascial pain syndromes
ABSTRACT  

Objective:To detect the core muscle group in the patients with myofascial pain syndromes(MPS) by using the surface electromyography;to detect the distribution of muscle fiber type by the analysis of the median frequency and the slope of the median frequency.

Methods:From October 2017 to March 2018,there were 100 patients with the MPS,including 45 males and 55 females;the average age was 48.5 years old,ranging from 29 to 76 years old. There were 40 cases of left back pain and 60 cases of right back pain. The course of illness was more than 6 months. Another 40 healthy patients without pain in the waist were included in the control group,20 males and 20 females;the average age was 47.3 years old,ranging from 29 to 76 years old. All the patients had different degrees of back pain and muscle stiffness,which were diagnosed as lumbar fasciitis by clinical and imaging examination. Surface electromyography was used to measure the characteristics of the lumbar core muscles (multifissions,iliocostal muscles,and longest muscle) of the three groups in the Biering-Sorensen testing,such as median frequency(MF) and absolute slope of median frequency (MFs).

Results:The MF values of the multifidus muscle in the three groups were as follows:the left side of the non-pain group was 133.88±26.61,and the right side was 131.39±29.81;left side of lift side pain group 117.29±10.93,right side 133.70±17.81;in the right pain group,the left side was 131.36±17.37,and the right side was 118.28±13.57. The MF values of the iliocostal muscle in the three groups were:106.94±28.01 on the left side of the non-pain group,114.68±18.96 on the right side;left side of lift side pain group 93.95±11.17,right side 107.60±27.86;in the right pain group,the left side was 105.93±15.52,and the right side was 97.27±19.27. The MF values of the longest muscle in the three groups were:109.24±26.20 on the left side of the non-pain group,112.58±17.70 on the right side. Left side of left side pain group 95.58±10.83,right side 108.79±26.39;in the right pain group,the left side was 106.50±17.98,and the right side was 98.20±11.16. The MFs values of the multifidus muscle in the three groups were:0.221±0.109 on the left side of the non-pain group,and 0.259±0.169 on the right side;left side of left side pain group 0.318±0.184,right side 0.210±0.159;in the right pain group,the left side was 0.258±0.169,and the right side was 0.386±0.166. The MFs values of the iliocostal muscles in the three groups were:0.241±0.158 for the left side of the non-pain group,and 0.238±0.128 for the right side. Left side of left side pain group 0.330±0.208,right side 0.252±0.171;in the right side pain group,left side 0.249±0.150,right side 0.343±0.144. The MFs values of the longest muscle of the three groups were:0.244±0.252 on the left side of the non-pain group,and 0.210±0.128 on the right side;left side of left side pain group 0.348±0.255,right side 0.241±0.224;in the right pain group,the left side was 0.239±0.155,and the right side was 0.334±0.233. There were no statistically significant differences in MF and MFs values of the left and right lumbar multifidus muscle,iliocostal muscle and longest muscle in the non-pain group(P>0.05). MF values of the pain side multifidus muscle,iliocostal muscle and longest muscle in the lumbago group were lower than those in the non-pain group(P<0.05). MFs values of the painful side multifidus muscle,iliocostal muscle and longest muscle in the low back pain group were higher than those in the non-pain group(P<0.05).

Conclusion:The muscle fatigue degree of the back muscle in the pain side of patients with MPs is decreased,and the muscle fiber type is dominated byⅡmuscle fiber.
KEY WORDS  Low back pain  Myofascial pain syndromes  Electromyography  Muscle fibers  skeletal
 
引用本文,请按以下格式著录参考文献:
中文格式:姜美驰,肖京,饶毅,赵兴丽,曹昺焱,庄威.腰背肌筋膜痛综合征核心肌群的表面肌电信号与肌纤维类型的相关性分析[J].中国骨伤,2019,32(6):544~548
英文格式:JIANG Mei-chi,XIAO Jing,RAO Yi,ZHAO Xing-li,CAO Bing-yan,ZHUANG Wei.Correlation analysis between the surface electromyography and muscle fiber types of the core muscle group in the patients with myofascial pain syndromes[J].zhongguo gu shang / China J Orthop Trauma ,2019,32(6):544~548
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