帕金森病早期患者双侧腓肠肌外侧头表面肌电图及踝关节运动学指标的变化

Emg and ankle kinematics of bilateral gastrocnemius lateral head in early Parkinson’s disease

目的:探讨帕金森病(PD)早期患者双侧腓肠肌外侧头表面肌电图及踝关节运动学指标的变化。方法:将30例PD早期患者(其Hoehn-Yahr分期为Ⅰ期)设为试验组,将30例健康志愿者设为对照组。在正常速度步行的状态下运用三维步态分析系统及表面肌电图对两组研究对象进行步态数据及双侧腓肠肌外侧头数据采集,运用smart-clinic分析软件对数据进行截取,对支撑期踝关节最大背屈角度、最大跖屈角度及双侧腓肠肌外侧头平均均方根值(ARMS)进行数据分析与比较。结果:与非严重受累侧下肢相比,试验组患者严重受累侧下肢的腓肠肌外侧头ARMS和踝关节最大背屈角度均更大,踝关节最大跖屈角度更小,P<0.05。与对照组健康人相比,试验组患者的双侧踝关节最大跖屈角度和双侧腓肠肌外侧头ARMS均更小,双侧踝关节最大背屈角度均更大,P<0.05。结论:PD早期患者腓肠肌外侧头的收缩强度较正常人有所下降,其踝关节最大背屈角度增大,最大跖屈角度减小。PD早期患者严重受累侧下肢的胫骨前倾角度、踝关节最大背屈角度和最大跖屈角度较非严重受累侧下肢的变化更为显著。

Objective:To investigate the changes of electromyography and ankle kinematics of bilateral gastrocnemius lateral head in patients with Parkinson's disease(PD)in early stage.Methods:thirty patients with early PD(hoehn-Yahr stageⅰ)were divided into experimental group and 30 healthy volunteers were divided into control group.Under the condition of walking at normal speed,3d gait analysis system and surface emG were used to collect the gait data and bilateral lateral head of gastrocnemius muscle of the two groups of subjects.Smart-clinic analysis software was used to intercept the data.The maximum dorsiflexion Angle,the maximum plantar-flexion Angle and the mean root mean square value(ARMS)of bilateral gastrocnemius lateral head were analyzed and compared.Results:Compared with the non-severely involved lower limbs,the lateral head ARMS of gastrocnemius muscle and the maximum dorsiflexion Angle of ankle joint were larger in the experimental group,and the maximum plantar-flexion Angle of ankle joint was smaller in the severely involved lower limbs,P<0.05.Compared with healthy people in the control group,the maximum plantar flexion Angle of bilateral ankle joint and bilateral gastrocnemius lateral head ARMS were smaller in the experimental group,and the maximum dorsiflexion Angle of bilateral ankle joint was larger in the experimental group,P<0.05.Conclusion:The contraction strength of the lateral head of gastrocnemius muscle in patients with early PD decreased compared with normal controls,and the maximum dorsiflexion Angle of ankle joint increased,while the maximum plantar flexion Angle decreased.The changes of tibial forward Angle,maximum dorsiflexion Angle and maximum plantar-flexion Angle of ankle joint in severely affected lower limbs were more significant than those in non-severely affected lower limbs in early PD patients.