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研究针对肱骨外上髁炎（网球肘）与前臂屈伸肌群协同失调的病理机制，开发了一种耦合腕部运动与抓握功能的前臂肌力协同训练装置。该装置通过生物力学优化设计实现了多关节联动训练模式，有效促进主动肌与拮抗肌的协调激活，避免常规单一维度肌力训练设备可能导致的拮抗肌群代偿性失衡。试验采用表面肌电信号量化分析，发现该训练系统可显著提高桡侧腕长伸肌（ECRL）与尺侧腕伸肌（ECU）的肌肉募集和做功水平（p<0.05）。持续两星期的干预训练后，经等速肌力测定，试验组肌力平衡指数（MBI）较基线值显著下降（p<0.01），表明屈肌与伸肌的力学输出趋于均衡?。在动态训练过程中，受试者前臂旋前/旋后运动的协同肌激活时序同步性提高，肌肉共收缩指数得到优化。该研究成果证实，融合多维度运动耦合的训练装置能有效重建前臂肌群动力平衡，为慢性肌腱病的精准康复提供了新思路。
Abstract：The study focuses on the pathological mechanism of elbow lateral epicondylitis (Tennis Elbow， TE) and the coordinated dysfunction of the forearm flexor and extensor muscle groups， developing a forearm muscle synergy training system that integrates wrist moving and gripping. Compared to conventional unidimensional strength training equipment， which may lead to compensatory imbalance of antagonist muscle groups， this device employs a biomechanical coupling design to achieve a multi-joint coordinated training model， effectively promoting the coordinated activation of the agonist and antagonist muscles. Surface electromyography signal analysis was used in the experiment， revealing that the novel training system significantly enhanced muscle recruitment and work output levels of the extensor carpi radialis longus (ECRL) and the extensor carpi ulnaris (ECU) (p<0.05). After a two-week intervention， isokinetic strength measurement showed that the muscle balance index (MBI) in the experimental group decreased (p<0.01) compared to baseline， indicating a more balanced mechanical output between the flexors and extensors. During dynamic training， the synchronization of the co-activation timing of the forearm pronation/supination muscles improved， and the muscle co-contraction index was optimized. The findings confirm that the training device， which integrates multi-dimensional motion coupling， effectively reconstructs the forearm muscle group’s kinetic chain balance， and its biofeedback mechanism offers a new approach for the precise rehabilitation of chronic tendinopathies.
[1] 朱家驹. 网球肘损伤机制的生物力学分析 [J]. 当代体育科技， 2022， 12(3): 23-26.
[2] Ikeda K， Yoshii Y， Kohyama S， et al. Pathophysiology of sex difference in refractoriness in lateral epicondylitis: Biomechanical study of wrist torque [J]. Journal of Orthopaedic Research， 2024， 42(2): 277-285.
[3] Alizadehkhaiyat O， Fisher A C， Kemp G J， et al. Upper limb muscle imbalance in tennis elbow: a functional and electromyographic assessment [J]. Journal of Orthopaedic Research， 2007， 25(12): 1651-1657.
[4] Ma K L， Wang H Q. Management of lateral epicondylitis: a narrative literature review [J]. Pain Research and Management， 2020， 2020(1): 6965381.
[5] Landesa-Pi?eiro L， Leirós-Rodríguez R. Physiotherapy treatment of lateral epicondylitis: a systematic review [J]. Journal of Back and Musculoskeletal Rehabilitation， 2022， 35(3): 463-477.
[6] Lepley L K， Lepley A S， Onate J A， et al. Eccentric exercise to enhance neuromuscular control [J]. Sports Health: A Multidisciplinary Approach， 2017， 9(4): 333-340.
[7] Goodall S， Thomas K， Barwood M， et al. Neuromuscular changes and the rapid adaptation following a bout of damaging eccentric exercise [J]. Acta Physiologica， 2017， 220(4): 486-500.
[8] Martinez-Silvestrini J A， Newcomer K L， Gay R E， et al. Chronic lateral epicondylitis: comparative effectiveness of a home exercise program including stretching alone versus stretching supplemented with eccentric or concentric strengthening [J]. Journal of Hand Therapy， 2005， 18(4): 411-420.
[9] Mannella K， Forman G N， Mugnosso M， et al. The effects of isometric hand grip force on wrist kinematics and forearm muscle activity during radial and ulnar wrist joint perturbations [J]. PeerJ， 2022， 10: e13495.
[10] 王健， 杨红春， 刘加海. 疲劳相关表面肌电信号特征的非疲劳特异性研究 [J]. 航天医学与医学工程， 2004， 17(1): 39-43.
[11] Gribble P L， Mullin L I， Cothros N， et al. Role of cocontraction in arm movement accuracy [J]. Journal of Neurophysiology， 2003， 89(5): 2396-2405.
[12] Alizadehkhaiyat O， Fisher A C， Kemp G J， et al. Strength and fatigability of selected muscles in upper limb: assessing muscle imbalance relevant to tennis elbow [J]. Journal of Electromyography and Kinesiology， 2007， 17(4): 428-436.
[13] Forman D A， Forman G N， Holmes M W R. Wrist extensor muscle activity is less task-dependent than wrist flexor muscle activity while simultaneously performing moderate-to-high handgrip and wrist forces [J]. Ergonomics， 2021， 64(12): 1595-1605.
[14] Holmes M W R， Tat J， Keir P J. Neuromechanical control of the forearm muscles during gripping with sudden flexion and extension wrist perturbations [J]. Computer Methods in Biomechanics and Biomedical Engineering， 2015， 18(16): 1826-1834.
[15] Lee J A， Sechachalam S. The effect of wrist position on grip endurance and grip strength [J]. The Journal of Hand Surgery， 2016， 41(10): e367-e373.
[16] Ozone K， Kokubun T， Takahata K， et al. Structural and pathological changes in the enthesis are influenced by the muscle contraction type during exercise [J]. Journal of Orthopaedic Research， 2022， 40(9): 2076-2088.
[17]黄夏， 刘志辉. 踝关节康复训练装置的优化设计与研究[J]. 东华大学学报(自然科学版)， 2022， 48(3): 55-62.
[18]鲍洁， 周立亚. 不同坐姿下的表面肌电特性及舒适度分析[J]. 家具与室内装饰， 2024， 31(5): 93-97.
[19] Ko Y M， Park S， Lim C H， et al. Study on the correlation between the imbalance of muscle strength and the score of EMG-biofeedback game at ankle joint in healthy adults [J]. The Journal of Korean Physical Therapy， 2015， 27(6): 386-391.
[20] H?gg G， Milerad E. Forearm extensor and flexor muscle exertion during simulated gripping work: an electromyographic study [J]. Clinical Biomechanics， 1997， 12(1): 39-43.
[21] Mogk J， Keir P. The effects of posture on forearm muscle loading during gripping [J]. Ergonomics， 2003， 46(9): 956-975.
基本信息:
DOI：10.19886/j.cnki.dhdz.2025.0261
中图分类号:TH789
引用信息:
[1]刘志辉,冉林杰,付轶男,等.基于协同肌肉收缩的前臂肌力失衡训练装置设计[J].东华大学学报(自然科学版)().DOI:10.19886/j.cnki.dhdz.2025.0261.
基金信息:
国家自然科学基金项目（52375236）
2026-07-02
2026-07-02
2026-07-02