表面肌电图在评定髌股疼痛综合征患者髌骨动态稳定中的应用

The dynamic stability of the patella in persons with patellofemoral pain

目的 利用自建表面肌电图的标准化测试分析髌股疼痛综合征（PFPS）患者股内侧肌（VM）与股外侧肌（VL）在控制髌骨运动中的变化特征.方法 选取PFPS患者7例（13个膝）作为病例组,另选健康志愿者10例（20个膝）作为对照组,并分别进行表面肌电图检查,测量蹲起运动VM和VL的平均波幅和峰值时限（TBP）.结果 PFPS组和对照组VM∶VL平均振幅比值分别为（0.97±0.31）和（1.09±0.36）,2组差异无统计学意义（P＞0.05）,2组下蹲时的平均比值（1.00±0.16）明显高于起立时的平均比值（0.83±0.15）（P＜0.05）.在蹲起时PFPS组的TBPVM较TBPVL延迟（8.77％±5.12％）与对照组（-1.45％±4.02％）的比较有统计学意义（P＜0.01）.结论 所用表面肌电图的标准化测试能发现本组PFPS患者下蹲时VM的峰值时限明显滞后于VL,可用于评定局部型PFPS患者术后或康复治疗前后的变化.

Objective To analyze the activity of the vastus medialis （VM） and vastus lateralis （VL） muscles in the dynamic stabilization of the patella in patients with patellofemoral pain （PFPS） using standard surface electromyographic （sEMG） tests.Methods This comparative study involved 7 patients with PFPS （13 knees） and 10 healthy subjects （20 knees）.They performed weight-bearing squat movements,and sEMG was employed to measure the mean amplitude and the time before peak （TBP） of their VM and VL muscles.Results There was no significant difference between the two groups in the ratio of the mean amplitudes of the VM and VL muscles.However,the ratio in both groups in squatting was significantly higher than when simply standing.In the PFPS group the average TBP delay of the VM relative to the TBP of the VL was significantly longer than in the control group during squat movements.Conclusions The delay in the TBP of the VM relative to the VL during squat movements could serve as a standardized test for assessing treatment effect in patients with local factor PFPS.