髌股关节疼痛综合征患者手术前后表面肌电图的比较分析

关键词：髌股疼痛综合征  表面肌电图  膝痛  股内侧肌  股外侧肌

Keywords:patellofemoral pain syndrome  surface electromyography  knee pain  vastusmedialis  vastuslateralis

摘要：

      摘要 目的：了解表面肌电图（sEMG）评定髌股疼痛综合征（PFPS）患者手术治疗前后股内侧肌（VM）和股外侧肌（VL）动态平衡的变化。 方法：分别对PFPS患者6例手术前后和健康者10例行sEMG测试、视觉模拟评分法（VAS）疼痛和Lysholm膝关节功能评分。 结果：健康人、PFPS术前和术后3组间平均振幅右VM∶VL比值分别为1.09±0.36、0.90±0.28和0.94±0.35，3组间的差异无显著性意义（P＞0.05）；3组VM与VL达峰值时限的差值（ΔTBP）分别为-1.45±4.02、7.55±5.84和-1.82±2.93，差异有显著性意义（P＜0.01），PFPS者术后较术前明显改善（P＜0.01），恢复到健康人水平（P＞0.05）。PFPS者VAS术后1.60±0.91较术前3.09±1.14减小（P＜0.01），Lysholm评分术后71.27±16.52较术前54.82±17.50明显提高（P＜0.01）。 结论：本研究sEMG标准化测试VM和VL的峰值时限，能敏感反映PFPS患者手术治疗前后髌骨在冠状面上动态平衡的变化。

Abstract:

      Abstract Objective: To demonstrate the use of surface electromyographic (sEMG) to evaluate the changes of dynamic stability of vastus medialis (VM) and vastus lateralis(VL) of patients with patellofemoral pain (PFPS) before and after surgery. Method: In order to do a parallel case study, 6 patients with PFPS (pre and post surgery) and 10 well-beings without PFPS were divided into three groups. The sEMG, visual analogue scale (VAS) and Lysholm knee score scale were employed to evaluate VM and VL muscles, pain and knee function respectively. Result: There was no significant difference between these three groups in the ratio of the mean amplitudes (P＞0.05). However, in regard to time before peak (ΔTBP) between VM and VL, the difference within these three groups were significant (P＜0.01). Furthermore, the ΔTBP of patients post surgery (-1.82±2.93) was substantial improved with a value of (P＞0.05), compared to pre surgery (7.55±5.84) (P＜0.01). The VAS of patients with PFPS decreased significantly after surgery (P＜0.01); on the contrary, the score of Lysholm knee score scale increased（P<0.01）. Conclusion: By using sEMG test, the TBP of VM and VL to be an effective method to study the changes of dynamic stability of patella movement of patients with PFPS pre and post surgery.