前交叉韧带重建术后患者下肢肌肉的激活时序与协同特征

doi:10.3969/j.issn.1006-9771.2026.06.009

Abstract

Abstract:

Objective To investigate the lower limb muscle synergy patterns during jumping in patients after anterior cruciate ligament reconstruction(ACLR).
Methods From March to November, 2022, 23 patients after ACLR were enrolled as observation group, and 24 healthy ones matched in height, body mass and exercise level were recruited as control group at Wuhan Sports University. Surface electromyography(sEMG)data of lower limb muscles were collected during a single-leg vertical jump task. Non-negative matrix factorization was applied for synergy analysis. The number of synergies, variance accounted for, synergy structure(muscle weight)and activation coefficient were extracted.
Results Three types of muscle synergy patterns were identified on the affected side and contralateral side of the observation group, and the control group. For Synergy 1, the weight of biceps femoris was higher on both the affected and contralateral sides than in the control group(P<0.01); the weight of semitendinosus was higher on the affected side than on the contralateral side(P<0.05). For Synergy 2, the weight of lateral gastrocnemius and soleus were higher on both sides of the observation group than in the control group(P<0.05). For Synergy 3, the weight of gluteus maximus was lower on the affected side than on the contralateral side and in the control group(P<0.05); the weight of tibialis anterior was higher on the affected side than on the contralateral side and in the control group(P<0.001); the weight of vastus lateralis was lower on the contralateral side than on the affected side and in the control group(P<0.001). In the observation group, the peak activation time and stop time of Synergy 3 were delayed bilaterally(P<0.05).
Conclusion Patients after ACLR exhibit altered structural and temporal characteristics of lower limb muscle synergy during jump task. The hamstrings show increased participation during the pre-activation phase, and calf muscles undertake more stabilizing functions during the landing phase.

Key words: anterior cruciate ligament reconstruction, muscle synergy, lower limb, non-negative matrix factorization

CLC Number:

R873

CHEN Peng, ZHANG Sizhuo, WANG Ling, ZUO Huiwu, ZHENG Cheng. Activation timing and synergy characteristics of lower limb muscles in patients after anterior cruciate ligament reconstruction[J]. Chinese Journal of Rehabilitation Theory and Practice, 2026, 32(6): 708-720.

Figures/Tables 9

Table 1

Table 2

Table 3

Table 4

Descriptive statistical results of muscle weight of muscle synergy structures of three groups"

变量	观察组患侧(n=23)		观察组健侧(n=23)		对照组(n=24)
变量	均值	标准差	均值	标准差	均值	标准差
协同元1
臀大肌	13.77	8.37	9.60	4.78	11.33	7.57
臀中肌	20.11	8.90	21.40	9.52	13.25	7.78
股直肌	6.74	4.10	5.14	3.70	9.59	9.39
股内侧肌	7.79	5.18	8.99	5.85	10.66	7.62
股外侧肌	6.28	4.91	5.88	5.32	7.93	7.67
半腱肌	32.41	14.20	23.13	11.33	24.37	14.83
股二头肌	33.07	13.36	33.63	12.55	21.82	11.92
腓骨长肌	31.57	12.17	39.65	9.29	33.22	11.24
腓肠肌内侧	51.85	8.97	56.68	6.31	53.50	7.73
腓肠肌外侧	34.20	11.04	33.63	10.03	44.63	9.33
比目鱼肌	30.22	12.09	25.50	12.06	34.19	14.19
胫骨前肌	14.56	10.52	15.12	7.05	8.83	7.85
协同元2
臀大肌	27.75	11.24	26.48	8.66	23.14	12.05
臀中肌	25.74	9.19	26.78	10.48	18.73	9.63
股直肌	46.61	10.85	42.79	5.46	44.52	7.84
股内侧肌	38.11	8.07	40.12	6.10	43.25	6.76
股外侧肌	42.18	8.26	43.01	6.39	41.76	5.52
半腱肌	7.93	8.04	15.26	10.25	11.25	10.22
股二头肌	15.29	8.34	13.55	8.00	19.21	12.49
腓骨长肌	22.99	6.49	20.03	10.11	23.21	11.96
腓肠肌内侧	7.51	5.82	5.73	6.08	4.73	5.64
腓肠肌外侧	20.00	10.93	16.75	9.78	7.92	6.54
比目鱼肌	24.29	10.65	22.24	11.71	13.31	10.59
胫骨前肌	17.52	12.30	27.72	10.92	34.82	10.68
协同元3
臀大肌	34.95	8.43	42.49	7.23	44.15	13.27
臀中肌	35.54	8.31	36.72	8.15	40.71	11.97
股直肌	27.81	11.36	17.05	14.27	25.04	7.12
股内侧肌	30.37	10.19	19.33	9.61	26.10	9.87
股外侧肌	32.76	9.75	17.84	10.73	28.53	7.00
半腱肌	33.75	9.75	42.93	12.43	36.12	13.39
股二头肌	22.73	12.22	26.68	13.78	26.06	7.13
腓骨长肌	20.33	10.09	20.95	12.77	15.57	9.13
腓肠肌内侧	3.15	5.22	3.91	3.49	2.71	3.87
腓肠肌外侧	12.91	8.70	23.20	9.92	16.49	9.61
比目鱼肌	11.16	10.24	22.60	12.76	19.42	14.58
胫骨前肌	36.27	10.71	20.91	14.47	14.64	11.91

Table 4

Table 5

Table 6

Post Hoc Bonferroni test results of muscle weight of muscle synergy structures among three groups"

协同及肌肉	组别		平均值差	P值	95%CI
协同及肌肉	组别		平均值差	P值	下限	上限
协同元1
臀中肌	观察组患侧	对照组	6.861	0.025	0.699	13.023
	观察组健侧	对照组	8.153	0.006	1.993	14.313
	观察组患侧	观察组健侧	-1.292	>0.999	-7.549	4.965
半腱肌	观察组患侧	对照组	8.035	0.130	-1.535	17.605
	观察组健侧	对照组	-1.237	>0.999	-10.807	8.333
	观察组患侧	观察组健侧	9.272	0.046	0.124	18.420
股二头肌	观察组患侧	对照组	11.251	0.009	2.369	20.133
	观察组健侧	对照组	11.808	0.006	2.924	20.692
	观察组患侧	观察组健侧	-0.557	>0.999	-9.569	8.455
腓骨长肌	观察组患侧	对照组	-1.651	>0.999	-9.413	6.111
	观察组健侧	对照组	6.431	0.138	-1.330	14.192
	观察组患侧	观察组健侧	-8.082	0.039	-15.961	-0.203
腓肠肌外侧	观察组患侧	对照组	-10.430	0.002	-17.587	-3.273
	观察组健侧	对照组	-10.999	0.001	-18.156	-3.842
	观察组患侧	观察组健侧	0.569	>0.999	-6.693	7.831
胫骨前肌	观察组患侧	对照组	5.730	0.072	-0.375	11.835
	观察组健侧	对照组	6.292	0.041	0.180	12.404
	观察组患侧	观察组健侧	-0.562	>0.999	-6.755	5.631
协同元2
臀中肌	观察组患侧	对照组	7.004	0.046	0.101	13.907
	观察组健侧	对照组	8.043	0.017	1.140	14.946
	观察组患侧	观察组健侧	-1.039	>0.999	-8.049	5.971
股内侧肌	观察组患侧	对照组	-5.142	0.041	-10.104	-0.180
	观察组健侧	对照组	-3.125	0.382	-8.085	1.835
	观察组患侧	观察组健侧	-2.018	0.975	-7.049	3.013
半腱肌	观察组患侧	对照组	-3.327	0.699	-10.06	3.406
	观察组健侧	对照组	4.002	0.452	-2.731	10.735
	观察组患侧	观察组健侧	-7.329	0.029	-14.162	-0.496
腓肠肌外侧	观察组患侧	对照组	12.079	<0.001	5.564	18.594
	观察组健侧	对照组	8.829	0.005	2.314	15.344
	观察组患侧	观察组健侧	3.251	0.686	-3.360	9.862
比目鱼肌	观察组患侧	对照组	10.983	0.003	3.127	18.839
	观察组健侧	对照组	8.932	0.019	1.077	16.787
	观察组患侧	观察组健侧	2.052	>0.999	-5.920	10.024
胫骨前肌	观察组患侧	对照组	-17.307	<0.001	-25.299	-9.315
	观察组健侧	对照组	-7.102	0.100	-15.09	0.886
	观察组患侧	观察组健侧	-10.205	0.008	-18.313	-2.097
协同元3
臀大肌	观察组患侧	对照组	-9.199	0.006	-16.278	-2.120
	观察组健侧	对照组	-1.659	>0.999	-8.738	5.420
	观察组患侧	观察组健侧	-7.540	0.033	-14.724	-0.356
股直肌	观察组患侧	对照组	2.777	>0.999	-5.174	10.728
	观察组健侧	对照组	-7.957	0.061	-15.938	0.024
	观察组患侧	观察组健侧	10.758	0.005	2.681	18.835
股内侧肌	观察组患侧	对照组	4.271	0.418	-2.782	11.324
	观察组健侧	对照组	-6.773	0.062	-13.826	0.280
	观察组患侧	观察组健侧	11.044	0.001	3.881	18.207
股外侧肌	观察组患侧	对照组	4.231	0.359	-2.251	10.713
	观察组健侧	对照组	-10.688	<0.001	-17.177	-4.200
	观察组患侧	观察组健侧	14.919	<0.001	8.344	21.494
半腱肌	观察组患侧	对照组	-2.374	>0.999	-11.054	6.306
	观察组健侧	对照组	6.806	0.158	-1.874	15.486
	观察组患侧	观察组健侧	-9.181	0.029	-17.990	-0.372
腓肠肌外侧	观察组患侧	对照组	-3.576	0.578	-10.369	3.217
	观察组健侧	对照组	6.712	0.058	-0.083	13.507
	观察组患侧	观察组健侧	-10.288	0.001	-17.182	-3.394
比目鱼肌	观察组患侧	对照组	-8.267	0.081	-17.417	0.883
	观察组健侧	对照组	3.175	>0.999	-5.973	12.323
	观察组患侧	观察组健侧	-11.442	0.008	-20.718	-2.166
胫骨前肌	观察组患侧	对照组	21.625	<0.001	12.867	30.383
	观察组健侧	对照组	6.269	0.258	-2.489	15.027
	观察组患侧	观察组健侧	15.356	<0.001	6.470	24.242

Table 6

Table 7

Table 8

Table 9

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指标	对照组(n=24)	观察组(n=23)	t/χ²值	P值
性别(女/男)/n	12/12	6/17	2.842	0.138
年龄/岁	22.5±1.5	21.5±1.3	-2.438	0.018
身高/cm	173.5±6.7	174.9±7.5	0.676	0.501
体质量/kg	63.1±8.6	67.1±9.0	1.558	0.126
体质量指数/(kg·m^-2)	20.9±1.6	21.9±2.0	1.897	0.070
伤前Tegner评分	8.2±0.6	8.3±0.6	0.571	0.767
国际膝关节文献委员会评分	100.0	95.7±2.4	-8.782	<0.001
单腿跳跃距离LSI/%	99.8±3.3	98.3±3.0	-1.628	0.103
单腿跳跃高度LSI/%	101.0±5.7	98.3±5.1	-1.709	0.101
优势侧(左侧/右侧)/n	0/24	0/23	<0.001	>0.999
损伤侧(左侧/右侧)/n	-	16/7		-
术后时间/月	-	16.4±5.7		-

协同元数	观察组患侧(n=23)		观察组健侧(n=23)		对照组(n=24)
协同元数	均值	标准差	均值	标准差	均值	标准差
1	86.91	2.16	86.42	2.60	86.21	4.17
2	93.11	1.26	93.17	1.58	92.91	2.01
3	96.03	0.84	96.20	1.07	96.20	1.35
4	97.48	0.63	97.60	0.73	97.32	0.86
5	98.45	0.43	98.55	0.49	98.41	0.51
6	99.08	0.23	99.15	0.29	99.03	0.32

协同元数	平方和	自由度	均方	F值	P值
1	6.260	2	3.130	0.322	0.725
2	0.895	2	0.447	0.164	0.849
3	0.466	2	0.233	0.189	0.828
4	0.952	2	0.476	0.851	0.431
5	0.250	2	0.125	0.546	0.582
6	0.175	2	0.088	1.093	0.341

协同元及肌肉	平方和	自由度	均方	F值	P值
协同元1
臀大肌	108.683	2	217.365	2.104	0.130
臀中肌	459.789	2	919.578	5.998	0.004
股直肌	134.195	2	268.389	3.083	0.052
股内侧肌	52.016	2	104.032	1.256	0.291
股外侧肌	30.126	2	60.252	0.764	0.470
半腱肌	610.730	2	1221.460	3.323	0.042
股二头肌	1051.463	2	2102.926	6.686	0.002
腓骨长肌	430.702	2	861.405	3.638	0.032
腓肠肌内侧	143.619	2	287.237	2.411	0.097
腓肠肌外侧	903.024	2	1806.047	8.921	<0.001
比目鱼肌	444.606	2	889.213	2.764	0.070
胫骨前肌	288.75	2	577.500	3.930	0.024
协同元2
臀大肌	134.394	2	268.789	1.178	0.314
臀中肌	448.243	2	896.485	4.809	0.011
股直肌	85.006	2	170.013	1.260	0.290
股内侧肌	159.206	2	318.411	3.263	0.044
股外侧肌	9.429	2	18.858	0.209	0.812
半腱肌	338.226	2	676.452	3.538	0.034
股二头肌	204.814	2	409.627	2.090	0.132
腓骨长肌	77.202	2	154.404	0.790	0.458
腓肠肌内侧	47.34	2	94.679	1.391	0.256
腓肠肌外侧	933.277	2	1866.554	10.910	<0.001
比目鱼肌	845.549	2	1691.097	6.766	0.002
胫骨前肌	1757.251	2	3514.502	14.157	<0.001
协同元3
臀大肌	576.471	2	1152.942	5.781	0.005
臀中肌	171.309	2	342.617	1.896	0.158
股直肌	722.954	2	1445.908	5.862	0.005
股内侧肌	741.528	2	1483.056	7.600	0.001
股外侧肌	1342.279	2	2684.558	16.425	<0.001
半腱肌	563.858	2	1127.717	3.813	0.027
股二头肌	109.11	2	218.220	0.833	0.439
腓骨长肌	203.497	2	406.994	1.791	0.174
腓肠肌内侧	8.878	2	17.756	0.488	0.616
腓肠肌外侧	674.887	2	1349.774	7.374	0.001
比目鱼肌	851.35	2	1702.700	5.228	0.008
胫骨前肌	2915.658	2	5831.315	19.138	<0.001

协同及指标	观察组患侧(n=23)		观察组健侧(n=23)		对照组(n=24)
协同及指标	均值	标准差	均值	标准差	均值	标准差
协同元1
T_start	7.74	6.10	11.64	5.56	9.03	8.73
T_stop	84.52	10.18	83.70	9.31	83.43	15.04
T_max	40.31	16.61	36.53	8.95	45.16	21.61
协同元2
T_start	32.18	17.59	39.58	15.84	31.16	24.65
T_stop	96.98	7.17	98.08	4.00	93.45	9.69
T_max	74.95	11.17	80.04	17.69	70.86	26.93
协同元3
T_start	41.37	21.78	36.06	32.30	23.89	24.40
T_stop	98.63	3.64	98.04	4.37	86.58	21.31
T_max	79.82	27.75	83.12	11.00	61.79	25.19

Activation timing and synergy characteristics of lower limb muscles in patients after anterior cruciate ligament reconstruction

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协同及指标	平方和	自由度	均方	F值	P值
协同元1
T_start	95.634	2	191.268	1.969	0.147
T_stop	7.849	2	15.698	0.056	0.946
T_max	453.508	2	907.016	1.637	0.202
协同元2
T_start	511.219	2	1022.438	1.302	0.279
T_stop	141.879	2	283.758	2.612	0.081
T_max	513.466	2	1026.932	1.310	0.277
协同元3
T_start	1921.238	2	3842.476	2.736	0.072
T_stop	1136.171	2	2272.342	6.830	0.002
T_max	3177.357	2	6354.714	6.221	0.003

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