老年不同类型肩胛骨动力障碍患者肩胛带肌表面肌电特征

Surface electromyography characteristics of shoulder girdle muscle in elderly patients with scapular dyskinesis of different types

目的观察老年不同类型肩胛骨动力障碍患者肩胛带肌运动时的表面肌电特征，探讨肩胛骨动力障碍和肩关节疾病发生的原因。方法选取29例肩胛骨动力障碍（scapulardyskinesis，SD）的老年患者作为SD组，根据Kibler分犁将SD组分为3个亚组：Ⅰ型亚组（n=9）、Ⅱ型亚组（n=10）和Ⅲ型亚组（n=10）；11例双侧肩胛骨对称的健康老年人作为对照组。应用表面肌电图测定左右两侧肩带肌在前屈和外展时的最大肌电振幅，比较各组的肌肉活动情况。结果SD患者的患侧肩关节前屈时，Ⅰ型亚组患侧斜方肌上束增强；Ⅱ型亚组患侧斜方肌上束和冈下肌增强，斜方肌中束减弱；Ⅲ型亚组患侧斜方肌上束增强，三角肌前束减弱。肩关节外展时，Ⅰ型亚组患侧斜方肌下束、前锯肌和三角肌前束减弱；Ⅱ型亚组患侧斜方肌上、中束，三角肌前、后束减弱；Ⅲ型亚组斜方肌上束活动较健侧增强，三角肌前束活动均较健侧减弱。结论不同类型的老年SD患者存在不同的肩胛带肌活动异常，这种异常可能是SD和肩关节疾病发生的原因。

Objective To observe the surface electromyography （sEMG） characteristics of shoulder girdle muscle in senile patients with scapular dyskinesis （SD） of different types and to explore the occurrence causes of SD and shoulder joint diseases. Methods 29 senile cases with SD were selected to be SD group, which was sub-divided into 3 sub-groups： sub- group Ⅰ（Kibler TypeⅠ, n =9）, sub-group Ⅱ（Kibler Type Ⅱ, n = 10） and sub-group Ⅲ （Kibler Type Ⅲ, n = 10） while 11 senile normal were selected to be control group; sEMG was applied in detecting the maximum EMG amplitude of shoulder girdle muscles on the right and left side at anteflexion and abduction. Results At the anteflextion of the lesion side, the in- creased activity in UT was found in cases in sub-group I, that in UT/IF in sub-group Ⅱ and that in UT in sub-group Ⅲl while the decreased activity in MT was found in cases in sub-group Ⅱ and that in AD in sub-group Ⅲ; at the abduction of the lesion side, the decreased activity in LT/SA/AD was found in cases in sub-group I, that in LT/MA/AD/PD in sub-group II and that in AD in sub-group Ⅲ while the increased activity in UT was found in cases in sub-group Ⅲ. Conclusions There exists an abnormal activity of shoulder girdle muscle in senile cases with SD of different types, which may be the occurrence causes of SD and should joint diseases.