中度S型青少年特发性脊柱侧凸胸腰背部肌电变化特征

关键词：中度青少年特发性脊柱侧凸  椎旁肌  表面肌电  时频特征  LZ复杂度

Keywords:moderate adolescent idiopathic scoliosis  paraspinal muscles  surface electromyography  time-frequency feature  Lempel-Ziv complexity

摘要：

      摘要 目的：采用表面肌电（sEMG）技术探讨中度S型青少年特发性脊柱侧凸（AIS）患者胸腰段凸凹侧椎旁肌肌电活动时域、频域及非线性指标变化特征。 方法：采集19例Cobb角为20—45°、S型AIS患者（男4例，女15例，年龄10—17岁）和21例健康对照组（男7例，女14例，年龄12—17岁）胸腰段椎旁肌表面肌电数据，记录凸、凹侧（健康受试者为左、右侧）EMG信号时域指标平均肌电值（AEMG）/均方根值（RMS）、频域指标中位频率（MF）/平均功率频率（MPF）及非线性指标LZ复杂度变化。 结果：与正常对照组相比，中度S型AIS患者胸段椎旁肌凸凹侧AEMG、RMS及其凸/凹侧比值、凸凹侧差异率有显著性差异；胸段凹侧AEMG、RMS低于凸侧，腰段凸侧的MF、MPF降低（P＜0.05）。中度S型AIS患者胸腰段椎旁肌LZ复杂度在不同状态下（静息状态、最大肌力、耐力收缩）差异有显著性意义（P＜0.001），其中收缩时高于静息状态时（P＜0.05），而最大肌力和耐力收缩时无显著性差异（P=0.326/0.233）；不同状态下凸侧与凹侧LZ复杂度无明显差异（P＞0.05）。 结论：中度S型AIS患者胸腰段椎旁肌凸凹侧肌电活动存在明显异常，其功能失调可能是脊椎运动障碍和侧凸进展并引起脊柱疼痛的关键病因。胸腰段椎旁肌肌电值变化可作为这一类型早期功能评估、疗效评价及疾病转归的重要手段，为加强和促进AIS防治工作及制定更有针对性、更有效的康复方案提供新的思路。

Abstract:

      Abstract Objective： To explore the changes in time-frequency and nonlinear indicators of thoracolumbar paraspinal muscle electromyographic activity in adolescents with moderate S-type idiopathic scoliosis (AIS) using surface electromyography (sEMG) technology. Method： Nineteen AIS adolescent patients （age： 11—17 years old， male： 4， female： 15） and twenty-one healthy adolescents（age： 12—17 years old， male： 7， female： 14） were separately performed EMG signals of maximum isometric voluntary contraction of the thoracic and lumbar paraspinal muscles. The data were analyzed with independent samples t-test to compare time-frequency changes of EMG activity of the lumbar multifidus. Two-way repeated measures analysis of variance （ANOVA） was adopted to compare Lempel-Ziv （LZ） complexity values in different states between two groups， with Bonferroni correction for multiple comparisons to assess differences in group means. Result： Compared with healthy controls， patients with moderate， S-shaped AIS showed significant decrease in average EMG （AEMG） and root mean square （RMS） of the concave side thoracic paraspinal muscles， and decrease median frequency （MF） and mean power frequency （MPF） of the convex side lumbar paraspinal muscles in the EMG measurements （P<0.05）. There were significant differences among LZ complexity in three states of resting state， maximum strength and strength endurance in AIS （P<0.001）. LZ complexity during resting state was significantly lower than that in contraction state （P<0.05）. Conclusion： Adolescents with moderate S-shaped exhibit significant abnormalities in the thoracolumbar paraspinal muscle electromyographic activity， which serves as important indicators for early functional assessment, treatment evaluation, and disease prognosis. This study provides new insights for enhancing AIS prevention, rehabilitation, and the development of targeted, effective therapeutic strategies.