肩胛骨动力障碍的分型表面肌电特征及优化康复动作研究

发布时间：2018-03-24 11:48

本文选题：肩胛骨动力学　切入点：表面肌电　出处：《北京体育大学》2017年硕士论文

【摘要】：目的:肩胛骨动力障碍表现为静止时肩胛骨位置和(或)运动时肩胛骨轨迹异常。其有三种不同类型,各型肩胛带肌群激活特点尚不明确,且不同康复动作的针对性效果有待进一步研究。本研究从肩胛骨动力障碍的分型着手,分析不同类型肩胛骨动力障碍肩胛带肌群的表面肌电特征,对比分析推肩俯卧撑及PNF上肢运动模式等康复动作中肩胛肌群的激活特征,为制定更有针对性的SD康复计划提供依据。方法:本研究招募北京体育大学上肢过顶项目运动员26名,按照肩胛骨动力障碍分型金标准方法,对26名受试者的每侧肩胛骨(52个肩次)进行分型,分为下角型(21人)、内侧缘型(11人)、上缘型(4人)和正常型(16人)。采集受试者在肩胛骨动力障碍分型动作、推肩俯卧撑及PNF上肢运动模式中肩胛带肌群的表面肌电数据。结果:(1)肩上举过顶运动员中肩胛骨动力障碍的发生率为69.2%,其中I型(下角型)占40.4%;IV型(正常型)为30.8%;II型(内侧缘型)占21.1%;III型(上缘型)为7.7%;(2)肩胛骨分型动作:上抬阶段,下角型靶肌肉激活模式变化不明显(P0.05),内侧缘型斜方肌下束(LT)激活水平低,斜方肌上束(UT)与斜方肌中束(MT)及LT的比值较高(P0.05);下降阶段,下角型LT及内侧缘型MT活动水平低,下角型UT与LT和前锯肌(SA)的激活比率以及内侧缘型UT/MT高(P0.05);(3)推肩俯卧撑动作:下角型SA激活水平及UT/SA低(P0.05);内侧缘型靶肌肉的活动水平达正常(P0.05),UT/MT明显较高(P0.01);(4)PNF上肢D1屈曲动作:两型UT与下角型MT的激活水平低(P0.05);两型靶肌肉的激活比率正常(P0.05);(5)推肩俯卧撑动作与PNF上肢D1屈曲相比,前者SA的激活水平高(P0.05),下角型UT/SA显著较低(P0.01);(6)PNF上肢D2动作:屈曲阶段内侧缘型SA、伸展阶段下角型MT、内侧缘型UT、MT的活动水平降低(P0.05);两型靶肌肉的激活比率正常(P0.05);结论:(1)无肩关节症状的肩上举过顶项目运动员亦存在肩胛骨动力障碍的可能,各型的分布为I型(下角型)IV型(正常型)II型(内侧缘型)III型(上缘型);(2)下角型肩胛骨动力障碍的关键肌为斜方肌下束和前锯肌,内侧缘型肩胛骨动力障碍的关键肌为斜方肌中、下束;(3)推肩俯卧撑动作对前锯肌的刺激效果优于PNF上肢D1屈曲动作,因此推肩俯卧撑动作适合于下角型肩胛骨动力障碍的康复;PNF上肢D1屈曲动作适合内侧缘型肩胛骨动力障碍的康复;(4)PNF上肢运动模式利于靶肌肉之间的激活比率的优化,对两种类型肩胛骨动力障碍均适用,但需在康复中后期加入。
[Abstract]:Objective: scapular motility disorder is characterized by abnormal scapular position and / or track during exercise. There are three different types of scapular dyskinesia, and the activation characteristics of scapular girdle muscle group in different types are not clear. The specific effects of different rehabilitation actions need to be further studied. In this study, the surface electromyography of different types of scapular dyskinesia was analyzed from the classification of scapular dyskinesia. The activation characteristics of scapular muscle group in the rehabilitation of shoulder push-ups and PNF upper limb movements were compared and analyzed. Methods: 26 athletes of Beijing University of physical Education were recruited to type gold according to scapular dynamic disorder. The scapular bones of each side of 26 subjects (52 shoulder times) were classified into inferior horn type (21 cases), medial marginal type (11 cases) and upper margin type (4 cases) and normal type (16 cases). Surface electromyography data of scapular band muscle group in shoulder push-ups and PNF upper limb motion mode. Results the incidence of scapular dyskinesia was 69.2 in the shoulder lift over top athletes, of which I (lower horn) accounted for 40.4g / IV (normal). 30.8Type II (medial margin type) accounted for 21.1D / III (upper margin type) scapular type (7.7m / 2) scapular type movement: lifting stage, 30.8% (medial margin type), 30.8% (medial margin type), 27.5% (upper margin type). The activation mode of target muscle of inferior horn type was not obvious (P0.05), the activity level of LTT of inferior trapezius muscle of medial margin type was low, the ratio of superior trapezius muscle (UTT) to middle trapezius muscle (MTT) and LT was higher than that of trapezius muscle, and the activity level of lower horn type LT and medial margin type MT was low in the descending stage, the ratio of MTT and LT in trapezius muscle was higher than that in trapezius muscle. The activation ratio of lower angle type UT to LT and sac) and the medial marginal type of UT/MT high level P0.05 / 3) push-ups: lower angle type SA activation level and UT/SA low P0.05 level; medial marginal type target muscle activity level to normal P0.05 UT / MT was significantly higher than that of P0.01 / 4NF-PNFD 1. The activation level of UT and MT in two types of UT was lower than that of type MT, and the activation ratio of target muscles of the two types was normal (P0.05 / 5) compared with the D1 flexion of PNF upper limb, the motion of push-ups of two types of UT was compared with that of D1-flexion of the upper limb of PNF. In the former, the activation level of SA was higher than that of P0.05G, and the UT/SA of the lower angle type was significantly lower than that of P0.01PNFD movement of the upper extremity: medial marginal type of SAA in flexion stage, lower angle type of MTT in extensional phase and UTT of medial margin type decreased the activity level of P0.05; the activation ratio of the two types of target muscles was normal P0.055.Conclusion: the activation ratio of the two types of target muscles is normal (P0.05). There is also the possibility of scapular dyskinesia in athletes who have no shoulder joint symptoms. The key muscles of type I (inferior horn type IV) (normal type II (medial margin type III) (upper margin type 2)) of inferior horn type of scapular dyskinesia were trapezius inferior bundle and anterior serratus muscle. The key muscle of medial marginal scapular dynamic disorder was trapezius muscle, and the stimulation effect of push shoulder push-ups on anterior serratus was better than that of D1 flexion of PNF upper limb. Therefore, pushing shoulder push-ups is suitable for the rehabilitation of lower angle scapular dyskinesia. The D1-flexion of PNF upper limb is suitable for the rehabilitation of medial marginal scapular dyskinesia. The PNF upper limb motion mode is beneficial to the optimization of the activation ratio between target muscles. For both types of scapular dyskinesia, but should be added in the middle and late stage of rehabilitation.
【学位授予单位】：北京体育大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R873;R493

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