杜氏肌营养不良患者上肢选择功能任务的生物力学分析：一项多病例研究

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2025-04-30 DOI:10.1016/j.clinbiomech.2025.106542

Agnieszka Sobierajska-Rek , Wiktoria Wojnicz , Bartłomiej Zagrodny , Michał Ludwicki , Katarzyna Pytka , Joanna Jabłońska-Brudło

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引用次数: 0

摘要

背景杜氏肌营养不良症的主要症状是肌肉组织的进行性萎缩。目前对这些患者运动测量的研究缺乏对临床条件下功能运动的整个轨迹的评估。本研究的主要目的是通过评估所选择的关节角度和肌肉活动对日常生活活动的功能运动的贡献，比较杜氏肌营养不良患者和健康对照者的上肢运动策略。方法提出了一种新的运动和肌电图模式评分方法，并对5名患者和1名健康对照者的整个上肢轨迹进行了评估。四个关节角和四个表面肌肉活动的贡献被评估为两个关系-运动学控制（肌肉活动和手腕位移之间的关系）和动态控制（肌肉活动和上肢质心位移之间的关系）。在垂直运动中，布鲁克评分较低的患者肩部和肘部活动度较高。在涉及重物水平移动的运动中，所有患者肘关节和斜方肌的贡献都高于对照组。该方法揭示了与健康对照组相比，杜氏肌营养不良患者的肌肉活动和上肢运动模式存在显著差异。在运动控制和动态控制方面的贡献评估结果显示了杜氏肌营养不良症患者的个体运动策略。

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Biomechanical analysis of upper limb of patients with Duchenne muscular dystrophy in chosen functional tasks: A multi-case study

Background

The main symptom of Duchenne muscular dystrophy is progressive wasting of muscle tissue. Current research on motor measurements for these patients lacks assessments of the whole trajectories of the functional motions over time in clinical conditions. The main goal of this study was to compare the upper limb movement strategy of patients with Duchenne muscular dystrophy and a healthy Control by assessing the contributions of chosen joint angles and contributions of muscles activity in the functional motions of activities of daily living.

Method

A novel score of kinematic and electromyographic patterns is proposed, and results are assessed for a whole trajectory of tested upper limb for five patients and a healthy Control. Contributions of four joint angles and four surface muscle activities are assessed for two relations – kinematic control (a relation between muscle activity and displacement of the wrist) and dynamic control (a relation between muscle activity and displacement of the center of mass of the upper limb).

Findings

In vertical motions, higher mobility in the shoulder and elbow was observed in patients with lower Brooke scores. In motions involving horizontal movement of a weight, the contribution of the elbow and the trapezius were higher in all patients vs the Control.

Interpretation

The proposed method revealed significant differences in muscle activity and upper limb movement patterns in patients with Duchenne muscular dystrophy compared with a healthy Control. Results of the assessment of contributions in kinematic control and dynamic control show individual movement strategies of patients with Duchenne muscular dystrophy.

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来源期刊

Clinical Biomechanics 医学-工程：生物医学

CiteScore

3.30

自引率

5.60%

发文量

189

审稿时长

12.3 weeks

期刊介绍： Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field. The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and technologies. Clinical Biomechanics aims to strengthen the links between laboratory and clinic by publishing cutting-edge biomechanics research which helps to explain the causes of injury and disease, and which provides evidence contributing to improved clinical management. A rigorous peer review system is employed and every attempt is made to process and publish top-quality papers promptly. Clinical Biomechanics explores all facets of body system, organ, tissue and cell biomechanics, with an emphasis on medical and clinical applications of the basic science aspects. The role of basic science is therefore recognized in a medical or clinical context. The readership of the journal closely reflects its multi-disciplinary contents, being a balance of scientists, engineers and clinicians. The contents are in the form of research papers, brief reports, review papers and correspondence, whilst special interest issues and supplements are published from time to time. Disciplines covered include biomechanics and mechanobiology at all scales, bioengineering and use of tissue engineering and biomaterials for clinical applications, biophysics, as well as biomechanical aspects of medical robotics, ergonomics, physical and occupational therapeutics and rehabilitation.