目的 比较两种主动直腿抬高(ASLR)动作的募集程度，并探讨相关肌群的募集模式。 方法 2018年6月至10月，选取11例健康受试者，记录动作A(连贯动作)和动作B(滞空10 s)单侧股直肌以及双侧腹直肌、腹外斜肌、腹内斜肌的表面肌电(sEMG)信号，并分析这些肌肉最大自主等长收缩(MVIC)时的募集程度(%MVIC)。 结果 在动作A中，同侧腹内斜肌和腹外斜肌募集程度大于对侧(t > 2.549, P < 0.05)；在动作B中，同侧的腹内斜肌、腹外斜肌和腹直肌募集程度大于对侧(t > 2.240, P < 0.05)；动作A时，双侧腹内斜肌和股直肌募集率更多(t > 3.549, P < 0.05)。 结论 两种ASLR动作都表现为同侧优势激活模式；在不同ASLR动作中，神经肌肉系统采取不同的运动控制策略。
Objective To compare the rate of recruitment in two types of active straight leg raise (ASLR) and to investigate the activation patterns of the related muscles. Methods From June to October, 2018, eleven healthy subjects were recruited. Surface electromyography (sEMG) signals of unilateral rectus femoris, bilateral rectus abdominis, internal oblique abdominis, external oblique abdominis and multifidus were recorded in normal ASLR (Action A) and raising leg for ten seconds (Action B). %maximal voluntary isometric contraction (MVIC) of these muscles was processed and analyzed. Results %MVIC of ipsilateral internal oblique muscle and external oblique muscle were greater than the opposite side (t > 2.549, P < 0.05) in Action A; %MVIC of ipsilateral internal oblique muscle, external oblique muscle and rectus abdominis muscle were greater than the opposite side (t > 2.240, P < 0.05) in Action B; compared with action B, Action A had higher %MVIC of bilateral internal oblique and rectus femoris (t > 3.549, P < 0.05). Conclusion The activation mode of ipsilateral dominance was shown in both actions, and the different motion control strategies may be adopted by the neuromuscular system in different ASLR.
1 GattiR, CortiM, CerviP, et al. Biomechanics of lower limb raising from the supine position [J]. Eura Medicophys, 2006, 42(3): 185-193.
2 MensJ M, VleemingA, SnijdersC J, et al. Validity of the active straight leg raise test for measuring disease severity in patients with posterior pelvic pain after pregnancy [J]. Spine, 2002, 27(2): 196-200.
3 O'SullivanP, DarrenJ, JulieA, et al. Altered motor control strategies in subjects with sacroiliac joint pain during the active straight-leg-raise test [J]. Spine (Phila Pa1976), 2002, 27(1): E1-E8.
4 HuH, MeijerO G, van Die?nJ H, et al. Muscle activity during the active straight leg raise (ASLR), and the effects of a pelvic belt on the ASLR and on treadmill walking [J]. J Biomech, 2010, 43(3): 532-539.
5 de GrootM, Pool-GoudzwaardA L, SpoorC W, et al. The active straight leg raising test (ASLR) in pregnant women: Differences in muscle activity and force between patients and healthy subjects [J]. Man Ther, 2008, 13(1): 68-74.
6 ShadmehrA, JafarianZ, TalebianS. Changes in recruitment of pelvic stabilizer muscles in people with and without sacroiliac joint pain during the active straight-leg-raise test [J]. J Back Musculoskelet Rehabil, 2012, 25(1): 27-32.
7 HuH, MeijerO G, HodgesP W, et al. Understanding the active straight leg raise (ASLR): an electromyographic study in healthy subjects [J]. Man Ther, 2012, 17(6): 531-537.
8 BealesD J, O'SullivanP B, BriffaN K. Motor control patterns during an active straight leg raise in pain-free subjects [J]. Spine (Phila Pa1976), 2009, 34(1): E1-E8.
9 BealesD J, O'SullivanP B, BriffaN K. Motor control patterns during an active straight leg raise in chronic pelvic girdle pain subjects [J]. Spine (Phila Pa1976), 2009, 34(9): 861-870.
10 MoellerC R, BlivenK C, ValierA R. Scapular muscle-activation ratios in patients with shoulder injuries during functional shoulder exercises [J]. J Athl Train, 2014, 49(3): 345-355.
11 李芳,郑洁皎. 表面肌电图在脑卒中患者异常步态分析中的研究进展[J]. 中国康复理论与实践, 2016, 22(10): 1159-1161.
12 SahrmannS, AzevedoD C, DillenL V. Diagnosis and treatment of movement system impairment syndromes [J]. Braz J Phys Ther, 2017, 21(6): 391-399.
13 LuiT K S, TsangS M H, KwokA W L. Changes in lumbopelvic movement and muscle recruitment associated with prolonged deep squatting: a pilot study [J]. Int J Environ Res Public Health, 2018, 15(5). pii: E1001. doi: 10.3390/ijerph15051001.
14 GirardJ, FerreP, PegorierJ P, et al. Muscles, Testing and Functions with Posture and Pain [M]. Wiley, 2005.
15 MensJ M, VleemingA, SnijdersC J, et al. The active straight leg raising test and mobility of the pelvic joints [J]. Eur Spine J, 1999, 8(6): 468-473.
16 Pool-GoudzwaardA L, VleemingA, StoeckartR, et al. Insufficient lumbopelvic stability: a clinical, anatomical and biomechanical approach to 'a-specific' low back pain[J]. Man Ther, 1998, 3(1): 12-20.
17 SnijdersC J, VleemingA, StoeckartR. Transfer of lumbosacral load to iliac bones and legs: Part 1: Biomechanics of self-bracing of the sacroiliac joints and its significance for treatment and exercise [J]. Clin Biomech, 1993, 8(6): 295-301.
18 孙悦,潘伟超,孙武栋,等. 多点多轴悬吊训练治疗非特异性腰痛的表面肌电研究[J]. 中国康复理论与实践, 2018, 24(9): 1058-1061.
19 MendellL M. The Size Principle: a rule describing the recruitment of motoneurons [J]. J Neurophysiol, 2005, 93(6): 3024-3026.
20 LaidlawD H. Steadiness is reduced and motor unit discharge is more variable in old adults [J]. Muscle Nerve, 2000, 23(4): 600-612.
21 WindhorstU. Muscle proprioceptive feedback and spinal networks [J]. Brain Res Bull, 2007, 73(4-6): 155-202.
22 ZajacF E, FadenJ S. Relationship among recruitment order, axonal conduction velocity, and muscle-unit properties of type-identified motor units in cat plantaris muscle [J]. J Neurophysiol, 1985, 53(5): 1303-1322.
23 LeitchM, MacefieldV G. Comparison of contractile responses of single human motor units in the toe extensors during unloaded and loaded isotonic and isometric conditions [J]. J Neurophysiol, 2015, 114(2): 1083-1089.
24 MacefieldV G, FuglevandA J, Bigland-RitchieB. Contractile properties of single motor units in human toe extensors assessed by intraneural motor axon stimulation [J]. J Neurophysiol, 1996, 75(6): 2509-2519.
