颈肩部疼痛及功能障碍与表面肌电图之间的关系

The relationship of neck/shoulder pain and disability and sEMG

目的探讨颈肩部疼痛及功能障碍与表面肌电图之间的关系。方法选择55例颈部或肩部疼痛的患者，采用视觉模拟量表（VAS）和颈椎功能障碍指数（NDI）评估患者颈肩疼痛和不适以及全身情况，采用表面肌电图（sEMG）评估患者颈肩部最大用力和持续打字时肌肉的功能状况，将表面肌电信号标准化处理后，比较VAS评分、NDI评分与标准化sEMG信号三者之间的相关性。按疼痛强度和功能障碍程度不同将患者分组，进一步比较其50％最大自主收缩（MVC）的波幅概率分布函数（APDF）。结果颈肩各部位的VAS评分与相应的50％MVC-APDF存在相关性，VAS评分的高低与颈肩部50％MVC-APDF大小变化一致，呈相关关系；而NDI评分与颈肩部50％MVC—APDF大小变化无相关关系；VAS评分和NDI评分之间亦存在相关性（P〈0．01）。按不同疼痛程度，将患者分为轻中度疼痛（VAS评分〈7分）和中度疼痛（VAS评分≥7分）组，2组颈肩部不同部位50％MVC—APDF比较，差异有统计学意义（P〈0．05）；按NDI评分将患者分成轻中度功能障碍（NDI评分〈25分）和重度功能障碍（NDI评分≥25分）组，2组颈肩不同部位50％MVC-APDF比较，差异无统计学意义（P〉0．05）。结论颈肩各部位的VAS评分与50％MVC-APDF之间存在相关性；颈肩疼痛程度不同，其所对应的50％MVC—APDF值亦有明显差异；NDI评分与50％MVC—APDF之间不存在相关性。

Objective To explore the relationship of neck pain, neck disability index （NDI）, and surface electromyography （sEMG） in subjects with work-related neck and shoulder musculoskeletal disorders. Methods Fifty-five patients with neck and shoulder pain participated in this study. VAS and NDI were used to evaluate the degree of pain and disability of the patients. The signals of maximum voluntary contraction （MVC） and typing status were recorded using the sEMG recording techniques. The amplitude of typing status was used to normalize the amplitude of MVC of each side of both neck and shoulders and the amplitude probability distribution function （APDF） of 50% MVC was calculated. Then, the relationship of VAS, NDI and the APDF values of each side of both neck and shoulders were compared. Results VAS was correlated to the NDI （P 〈 0.01 ） and the APDF of 50% MVC and the later had significant differences according to different degrees of pain [ mild to moderate pain （ VAS 〈 7 ） versus severe pain （VAS I〉7） ] ; NDI had no relationship with the APDF of 50% MVC and the later had no significant differences according to different degrees of NDI [ mild to moderate （NDI 〈 25） versus severe pain （NDI≥25） ]. Conclusion VAS was correlated to the APDF of 50% MVC and the later had significant differences according to different degrees of pain; but NDI had no relationship with the APDF of 50% MVC.