闭链与开链运动对髌股疼痛综合征股四头肌作用的表面肌电图研究

关键词：髌股疼痛综合征  闭链运动  开链运动  表面肌电图

Keywords:patellofemoral pain syndrome  open kinetic chain  close kinetic chain  surface electromyography

摘要：

      摘要 目的：利用表面肌电图(sEMG)对髌股疼痛综合征（patellofemoral pain syndrome, PFPS）患者双足半蹲伴或坐位伸膝动作下股四头肌进行评估,比较不同开链与闭链动作对股四头肌的作用差异。 方法：PFPS病例组及正常对照组各30例，分别在双足半蹲以及坐位伸膝动作时检测股外侧肌(vastus lateralis, VL)及股内斜肌（vastus medialis oblique, VMO）表面肌电图，分析时域、频域指标，比较其平衡关系。 结果：病例组双足半蹲动作与坐位伸膝动作时各肌电指标的VL/VMO比值在时域、频域指标均有显著性差异，在坐位单侧完全伸膝动作时VL/VMO肌电比值大于双足半蹲动作且>1。 结论：VL、VMO表面肌电指标在双足半蹲动作时较坐位单侧完全伸膝动作时更接近平衡，提示适当屈膝时的闭链运动能够更有选择性地激发VMO，这为PFPS的康复治疗的动作选择提供参考。

Abstract:

      Abstract Objective:To investigate the different effects of closed-kinetic chain and open-kinetic chain exercise on the imbalance between vastus lateralis (VL) and vastus medialis oblique (VMO) of patients with patellofemoral pain syndrome (PFPS) by surface EMG(sEMG) study. Method:Thirty patients with PFPS were selected to the study group, while 30 healthy matched subjects were enrolled as the control group. VL and VMO activities were recorded with sEMG during double-leg semisquat(DS) and fully knee extension in sitting position(KS). All the sEMG datas were collected and analyzed on extracting frequency and time domain indexes. Result:The differences in the time and frequency domain indexes of VL and VMO were significant for the study group. The VL/VMO ratio of all the indexes were significantly higher in the test of DS than in the test of KS (P<0.05) for both study group and control group, the ratio of VL/VMO sEMG was >1. Conclusion:Exercise in DS could promote more balanced VL and VMO activation than in KS. The finding indicated that more selective VMO activation obtained in closed kinetic chain exercises at 60°knee flexion. This may be of importance in designing training programs aimed toward control of the patellofemoral joint.