| 黄家宝,张桂芳,陈子昱,张振发,陈春麟,王楚怀.青少年特发性脊柱侧凸预期姿势调节凸凹侧不对称性的多模态神经机制研究[J].中国康复,2026,41(9):533-539 |
| 青少年特发性脊柱侧凸预期姿势调节凸凹侧不对称性的多模态神经机制研究 |
| Multimodal investigation of anticipatory postural adjustments in AIS: Convex/concave asymmetry across central, peripheral, and biomechanical dimensions |
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| DOI：10.3870/zgkf.2026.09.004 |
| 中文关键词: 青少年特发性脊柱侧凸 预期姿势调节 椎旁肌不对称 事件相关去同步化 姿势控制 凸/凹侧映射 |
| 英文关键词: adolescent idiopathic scoliosis anticipatory postural adjustments paraspinal muscle asymmetry event-related desynchronization postural control convex/concave mapping |
| 基金项目:国家自然科学基金（82172532）；广东省康复医学临床医学研究中心项目（2023B110003） |
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| 中文摘要: |
| 目的：探讨青少年特发性脊柱侧凸(AIS)患者在预期姿势调节(APA)过程中大脑皮层激活、椎旁肌肌肉激活及姿势控制行为学改变。方法：纳入健康对照11例、轻度AIS 14例及中度AIS 13例。受试者完成快速双侧举臂任务，同步采集脑电图、表面肌电图与测力台压力中心数据。以肌电动作时刻为锚点提取单次举臂脑电指标，经离群值清洗后汇总。采用混合线性模型与协方差分析逐级检验。结果：轻度组凸侧椎旁肌整合肌电低于凹侧，中度组反转呈高能耗代偿（P=0.006），该不对称性随任务重复加剧（P=0.005）。运动准备电位幅值呈健康对照>轻度>中度梯度（P=0.018）。体质量指数同时调控中枢运动准备时间（P=0.007）与外周姿势力学输出。胸弯亚组敏感性分析一致。结论：AIS患者APA异常主要表现为椎旁肌凸/凹侧能量分配失衡，且随任务重复出现疲劳相关加重。体质量指数是APA调控中被忽视的重要混淆因素，可能通过惯性负荷影响皮质准备时序和姿势力学输出。凸/凹侧映射结合EEG-sEMG-COP同步分析有助于识别AIS神经肌肉调控缺陷。 |
| 英文摘要: |
| Objective: To investigate the central-peripheral-biomechanical features of anticipatory postural adjustments in adolescent idiopathic scoliosis (AIS) during a rapid arm raise task. Methods: Totally, 38 subjects were enrolled: 11 healthy controls, 14 mild AIS, and 13 moderate AIS. Participants performed rapid bilateral arm raises while 32-channel electroencephalography, surface electromyography of eight trunk muscles, and force platform center of pressure (COP) data were synchronously recorded. Single-trial EEG movement-related cortical potentials and event-related desynchronization were extracted using sEMG-detected movement onset as the temporal anchor and aggregated after group-level outlier cleaning. Statistical analysis combined trial-level linear mixed models with subject-level analysis of covariance in a hierarchical strategy. Results: The mild group showed lower convex-side paraspinal integrated EMG than the concave side, whereas the moderate group exhibited a reversed pattern with high-energy convex-side compensation (P=0.006). Movement-related cortical potential amplitude followed an health control > mild > moderate gradient (P=0.018). Body mass index independently modulated both central motor preparation timing and peripheral postural mechanical output (P=0.007). Thoracic-curve sensitivity analysis confirmed these findings. Conclusion: The primary APA abnormality in AIS is convex/concave paraspinal energy maldistribution that worsens during repeated rapid movements. BMI may modulate both cortical preparation timing and biomechanical postural output through inertial loading. Convex/concave mapping combined with synchronized EEG-sEMG-COP analysis may help characterize neuromuscular control deficits in AIS and may provide a basis for individualized fatigue-aware rehabilitation assessment. |
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