电子测量与仪器学报

徐瑞,张恒瑜,梁军,王紫尧,刘佳雯,万春晓,明东.基于肌肉协同的临床步态功能定量评定方法[J].电子测量与仪器学报,2022,36(11):50-60

基于肌肉协同的临床步态功能定量评定方法

Quantitative method for assessing clinical gait functionbased on muscle synergy

DOI：

英文关键词:sEMG muscle synergy stroke lower extremity motor function assessment turning tasks

基金项目:科技部重点研发计划项目（2020YFC2004300,2020YFC2004302）、国家自然科学基金 (81901860, 61877042, 82101448)项目资助

作者	单位
徐瑞	1. 天津大学医学工程与转化医学研究院，2. 天津大学精密仪器与光电子工程学院
张恒瑜	1. 天津大学医学工程与转化医学研究院
梁军	2. 天津大学精密仪器与光电子工程学院，3. 天津医科大学总医院康复科
王紫尧	1. 天津大学医学工程与转化医学研究院
刘佳雯	1. 天津大学医学工程与转化医学研究院
万春晓	3. 天津医科大学总医院康复科
明东	1. 天津大学医学工程与转化医学研究院，2. 天津大学精密仪器与光电子工程学院

Author	Institution
Xu Rui	1. Academy of Medical Engineering and Translational Medicine，Tianjin University，2. College of Precision Instrument and Optoelectronics Engineering,Tianjin University
Zhang Hengyu	1. Academy of Medical Engineering and Translational Medicine，Tianjin University
Liang Jun	2. College of Precision Instrument and Optoelectronics Engineering,Tianjin University,3. Department of Rehabilitation Medicine, Tianjin Medical University General Hospital
Wang Ziyao	1. Academy of Medical Engineering and Translational Medicine，Tianjin University
Liu Jiawen	1. Academy of Medical Engineering and Translational Medicine，Tianjin University
Wan Chunxiao	3. Department of Rehabilitation Medicine, Tianjin Medical University General Hospital
Ming Dong	1. Academy of Medical Engineering and Translational Medicine，Tianjin University，2. College of Precision Instrument and Optoelectronics Engineering,Tianjin University

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中文摘要:

步态功能评估是脑卒中运动功能评估中的重要组成部分。为解决临床步态功能评估主观性大,主要依据运动学结果而非神经肌肉变化进行评估的问题,本文提出基于表面肌电(surface electromyography,sEMG)信号的肌肉协同(muscle synergy)分析方法对步态功能进行定量评定。使用非负矩阵分解( non-negative matrix factorization,NMF)算法对预处理后的多通道 sEMG 信号进行分解,计算不同组别不同任务下的协同结构向量相似性,得到协同稳定指数( synergy stability index,SSI)对患者步态功能进行评估。组间比较结果表明,测试腿在内侧转弯时,健康对照与患者健侧腿之间的 SSI 差异显著( p = 0. 010),与患者患侧腿之间的 SSI 也存在显著差异(p = 0. 007);测试腿在外侧转弯时,健康对照与患者患侧腿之间的 SSI 差异显著( p = 0. 036);任务间比较结果表明,患者健侧腿在外侧转弯时的 SSI 显著高于内侧转弯(p = 0. 017)。且外侧转弯时患者患侧腿的 SSI 与临床运动功能量表下肢部分 FMA_LE 显著相关(r = 0. 671,r 2 = 0. 451,p = 0. 033)。由结果可知,转弯任务下的 SSI 可为临床步态功能的评估提供一种客观的分析手段,从神经肌肉角度为定量评估提供一种新的思路。

英文摘要:

Gait assessment is one of the most important part of motor assessment of stroke. The clinical gait function assessment is subjective and based on kinematic results rather than neuromuscular changes. Therefore, a muscle synergy analysis method based on surface electromyography (sEMG) signals was proposed for quantitative assessment of gait function. The non-negative matrix factorization (NMF) algorithm was used to decompose the pre-processed multichannel sEMG signals. The synergy stability index (SSI) was obtained to describe the similarity of synergy structure vectors under different tasks in different groups. The between-group comparison showed significant differences in SSI between the healthy control and the patient’ s unaffected leg ( p = 0. 010) and between the SSI of the patient’s affected leg (p = 0. 007) when the tested leg was turned medially; the SSI of the healthy control leg was significantly different from the patient’s affected leg when the tested leg was turned laterally (p = 0. 036). The between-task comparison showed that SSI of the patient’s unaffected leg was significantly higher in the lateral turn than in the medial turn (p = 0. 017); the SSI of the patient’s affected leg during the lateral turning was significantly correlated with the lower extremity portion of the clinical motor function scale FMA_LE (r = 0. 671, r 2 = 0. 451, p = 0. 033). The experimental results suggested that SSI under the turning task can provide an objective and quantitative means of analysis for the assessment of clinical gait function, providing a new way for quantitative assessment from a neuromuscular perspective.

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