股四头肌常用康复训练动作的表面肌电分析

Surface Electromyography Analysis of Commonly Used Quadriceps Rehabilitation Exercises

目的比较目前常用的5种康复训练动作中股四头肌肌肉发力程度、股内侧肌与股外侧肌的肌肉发力平衡情况。方法14名健康受试者分别进行静蹲、股四头肌静力收缩、短弧伸膝、直腿抬高以及坐位伸膝等5种方式的膝关节康复训练动作,使用Delsys无线表面肌电测试系统采集训练时股内侧肌、股直肌与股外侧肌的肌电信号。分析5种康复动作各肌肉积分肌电与股内侧肌与股外侧肌发力平衡性。结果5项康复训练肌肉发力平衡性中静蹲训练与短弧伸膝、直腿抬高存在显著差异(p<0.05,p<0.05),静力收缩与短弧训练存在显著差异(p<0.05)。因动作发力方式不同,将5种动作分为动力性与静力性进行发力程度对比。3项动力性训练中,直腿抬高训练股直肌iEMG值与短弧伸膝、坐位伸膝存在非常显著差异性(p<0.01,p<0.01),股内侧肌与股外侧肌发力无显著差异(p>0.05);两项静力性训练中,静力收缩时股直肌与股外侧肌iEMG值显著高于静蹲(p<0.05),股内侧肌发力无显著差异(p>0.05)。结论在目前常用的5种康复训练动作中,静蹲训练股内侧肌与股外侧肌发力平衡值最高;动力性康复训练中直腿抬高相比短弧伸膝、坐位伸膝可更有效刺激股直肌;静力性收缩中股四头肌静力收缩可以有效刺激股直肌和股外侧肌。康复训练中应根据患者股四头肌发力障碍特点选择适合的康复动作。

Objective To compare the quadriceps muscle activity and the balance of vastus medialis muscle and vastus lateralis muscle in the 5 commonly used rehabilitation exercises.Methods 14 healthy subjects underwent 5 kinds of knee rehabilitation exercises in different modes,static squat,quadriceps isometric contractions,short arc exercise,the straight leg-raise and knee extension in sitting position.Surface electromyography was used to test the iEMG value of the vastus lateralis(VL),rectus femoris(RF)and vastus medialis oblique(VMO)during training,and calculate the VMO:VL ratio during 5 different quadriceps rehabilitation exercises.Results There were significant differences among 5 exercises in VMO:VL ratio.Static squat were significantly higher than short arc exercise and straight leg-raise(p<0.05,p<0.05),and there was a significant difference between isometric contraction and short arc exercise(p<0.05).Because of the different mode of action,the five exercises are divided into dynamic type and static type.Among the three dynamic exercises,there was a significant difference in iEMG of rectus femoris between the straight leg-raise with the short arc exercise and knee extension in sitting position(p<0.01,p<0.01).In the two static exercises,the iEMG value of RF and VL during quadriceps isometric contractions were significantly higher than that of the static squat(p<0.05).Conclusion Among the five commonly used rehabilitation exercises,static squat is the best exercise in the effort of VMO:VL,straight leg-raise in dynamic rehabilitation training can more effectively stimulate the rectus femoris of quadriceps compared with short arc exercise and knee extension in sitting position,and quadriceps isometric contractions in static rehabilitation training can effectively stimulate the vastus lateralis and rectus femoris.The suitable rehabilitation exercises should be selected according to the characteristics of the patient's quadriceps disorder in rehabilitation training.