北京生物醫(yī)學(xué)工程

基于肌肉機(jī)械功的異常步態(tài)分析

Abnormal gait analysis based on muscle mechanical work

作者：黃美蘭熊保平史武翔陳婷婷杜民

單位：1福州大學(xué)物理與信息工程學(xué)院（福州 350116） 2福州大學(xué)福建省醫(yī)療器械和醫(yī)藥技術(shù)重點(diǎn)實(shí)驗(yàn)室（福州 350116）

關(guān)鍵詞：肌肉機(jī)械功；量化分析；肌肉協(xié)同；神經(jīng)肌肉骨骼模型；肌電；偏癱

分類(lèi)號(hào)：R318.04

出版年·卷·期（頁(yè)碼）：2020·39·1（21-28）

摘要：

目的通過(guò)量化背屈肌和跖屈肌之間的協(xié)同作用分析不同行走速度下偏癱受試者踝關(guān)節(jié)角度的異常，以深層次地分析患者的運(yùn)動(dòng)功能。方法將從肌電（electromyograph，EMG）驅(qū)動(dòng)的人體肌肉骨骼模型中獲得的肌力、力臂和關(guān)節(jié)角度參數(shù)進(jìn)行預(yù)處理，利用肌力和力臂差計(jì)算的患側(cè)跖屈肌群和背屈肌群做功情況來(lái)解釋由踝關(guān)節(jié)角度曲線(xiàn)反映出的步態(tài)異常。結(jié)果跖屈肌群（主要是比目魚(yú)肌和腓腸肌）過(guò)度活躍做正功，保持高強(qiáng)度向心收縮，背屈肌群（主要是脛骨前肌）無(wú)力幾乎不做功導(dǎo)致肌肉協(xié)同失衡，從而引起步態(tài)異常。結(jié)論本文提出的量化肌肉機(jī)械功方法可以深層次地分析肌肉之間的協(xié)同作用，對(duì)于偏癱患者異常步態(tài)的分析具有重要的意義。

Objective The abnormal ankle angles of the subject are analyzed by quantizing the coordination between ankle dorsal and plantar flexors at different speeds to further analyze the patients' motor function. Methods The muscle strength, arm and joint angle obtained from the EMG-driven human musculoskeletal model are pre-processed, and the mechanical work of the dorsal and plantar flexors of hemiplegia side calculated by muscle strength and force arm difference are used to explain the anomaly reflected by the ankle joint angle curve.Results The plantar flexors are overactive and doing positive work， maintaining high-intensity centripetal contraction (mainly soleus and gastrocnemius) and the dorsal flexors weakness are almost unworked (mainly the tibialis anterior muscle) cause muscle coordination imbalance, leading to abnormal gait.Conclusions The method of quantitative muscle mechanical work proposed in this paper can deeply analyze the coordination relationship between muscles, and it is of great significance for the analysis of abnormal gait in patients with hemiplegia.

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