【作者】 缪芸；

【导师】 倪朝民；

【作者基本信息】 安徽医科大学 ， 康复医学与理疗学， 2010， 硕士

【摘要】 目的探讨膝部损伤后膝关节功能障碍对股四头肌功能的影响。方法选择30例单侧膝部损伤后膝关节功能障碍患者,在膝屈曲15°、30°采用表面肌电(sEMG)和测力仪检测并记录膝最大伸展等长收缩(MVIC)时的力矩、股外侧肌(VL)、股内侧肌(VMO)和股直肌(RF)的表面肌电信号。其中13例屈膝角度达到60°的患者,在膝屈曲60°测定最大随意收缩(MVC)伸膝力,以20% MVC为负荷进行坐位完全伸膝等长收缩测试。结果健患侧比较,患侧膝屈曲15°、30°膝最大伸展MVIC时的力矩,VL、VMO和RF的AEMG,MPF、MF值均低于健侧(P<0.01);膝屈曲15°MVIC时:AEMG,MF的VL/VMO比值健、患侧之间无显著性差异,MPF的VL/VMO比值健侧大于患侧,差异有显著性意义(P<0.01),在屈膝30°MVIC时,AEMG、MPF、MF的VL/VMO比值健、患侧之间无显著性差异;坐位完全伸膝时健侧VL的MPFs、MFs、大于患侧(P<0.01),VMO、RF的MPFs、MFs之间无显著性差异。不同肌肉之间比较,健侧:在屈膝15°、30°最大膝伸展MVIC时, VL的AEMG、MPF大于RF、VMO,具有不同程度的差异(P<0.01或P<0.05), MF各肌肉部分之间无显著性差异。患侧:屈膝15°、30最大膝伸展MVIC时,RF的AEMG、MPF值大于VL、VMO,差异具有显著性意义(P<0.01或P<0.05)。屈膝15°:RF的MF值大于VL、VMO,差异具有显著性意义(P<0.01或P<0.05),屈膝30°:MF在VL与RF之间无显著性差异,但均大于VMO(P<0.05)。不同角度之间比较,健侧:AEMG、MPF在15°与30°相对应肌肉之间无显著性差异,VL的MF值在在15°与30°之间有显著性差异(P<0.05), VMO、RF的MF值在15°与30°间无显著性差异;在患侧AEMG、MPF及MF在15°与30°相对应肌肉之间无显著性差异;健、患侧的MPF、MF、AEMG的VL/VMO比值在15°与30°之间差异均无统计学意义。结论sEMG能够定量地评价膝部损伤后膝关节功能障碍患者的肌肉功能。膝关节功能障碍患者患肢股四头肌肌力及肌肉活动水平显著降低;股直肌受影响程度较轻;膝关节功能障碍患者股四头肌存在选择性Ⅱ型纤维萎缩,未见明显肌肉耐力下降。更多还原

【Abstract】 ObjectiveTo explore how jiont dysfunction affects quadriceps muscles function in patients with unilateral knee injuryMethods30 unilateral knee injured patients with jiont dysfuntion were assesed for isometric EMG activity of vastus lateralis(VL)、vastus medialis obliques (VMO) and rectus femoris(RF)of both thighs during three 5-s maximal isometric voluntary contractions at a knee joint angle of 15°、30°(0°_ full knee extension) ,and torque were recorded at same time . At full knee extention in sitting position 20% maximal voluntary contraction (MVC), the EMG of the rectus femoris (RF), vastus lateralis (VL) and VM muscle were established in 13 unilateral knee injured patients with jiont dysfunction who knee active range were 60°or more than 60°.ResultsBetween unaffected side and affected side, The AEMG、MPF values of VL、VMO and RF muscles in affected knees are significantly lower during maximal isometric voluntory contraction at knee15°、30°flexion than those in unaffected knees, as well as the torque, Additionally,the VL/VMO ratio of MPF, MF,AEMG are similar in both side during MVIC at knee flexion of 15°and 30°except MPF of knee flexion of 15°. At full knee extention in sitting position 20% maximal voluntary contraction (MVC), MPFs and MFs of VL in unaffected side were greater than affected side, MPFs、MFs of VMO and RF were not different in both side. different heads of quadriceps , In unaffecteed side , at knee 15°、30°flexion, the AEMG、MPF values of VL are greater than VMO and RF, the MF of VL、VMO and RF were not significantly different.In unaffecteed side , at knee 15°、30°flexion, the AEMG、MPF and MF values of RF are greater than VMO and VL(P<0.01 or P<0.05), MF values of RF are greater than VMO and VL(P<0.01 or P<0.05)at knee 15°flexion, MF values of VL and RF were not significantly different but all greater than VMO at knee 30°flexion (P<0.05).Between two knee flexion angle, In unaffecteed side, AEMG、MPF of VL、VMO and RF between knee 15°and 30°flexion were not significantly diffirent,MF of VMO、RF were not significantly different between two knee flexion angle except VL; In affected side ,AEMG、MPF、MF of VL、VMO and RF between knee 15°and 30°flexion were not significantly different, the VL/VMO ratio of MPF, MF,AEMG are similar in both angle.ConclusionsEMG can provide quantitative measurements of muscle function, the isometric strength and neuromuscular acvtive lever are lower in affected limb in knee injured patients with knee dysfunction. RF may be affected less more than VL and VMO , It is suggested that the increases or same in endurance of the involved muscle may have been due, in part to selective Type II fiber atrophy in the involved muscle.Rehabilitation should focous on muscle strength increasment.更多还原