Kakebeeke T H, Lechner H, Baumberger M, Denoth J, Michel D, Knecht H
Swiss Paraplegic Center, 6207 Nottwil, Switzerland.
Spinal Cord. 2002 May;40(5):236-43. doi: 10.1038/sj.sc.3101282.
To measure spasticity of the knee flexors and extensor muscles in two different hip positions.
Swiss Paraplegic Center Nottwil, Switzerland.
Twenty spinal cord injured (SCI) patients with complete lesions were tested with a torque-velocity dynamometer in the following positions: (1) supine with a hip angle of 0 degrees; (2) sitting with a hip angle of 90 degrees. The excursion of the knee was measured for both positions using a goniometer. Two flexion/extension movements of the knee were performed at a speed of 10 degrees per sec. A further four flexion/extension movements over the same trajectory were made at a speed of 120 degrees per sec. Eccentric peak torques were measured continuously during movement of both legs for both speeds.
At a speed of 120 degrees per second, there was a significant difference in stretch reflex of the hamstrings and quadriceps femoris muscles for the two positions (Wilcoxon's paired t-test, P<0.05). Excitability was higher for the quadriceps femoris muscles in supine than in sitting position. For the hamstrings, the effect was reversed. Significant differences between sitting and supine position were not found for the speed of 10 degrees per sec. Test-retest reliability was high for the movements of 120 degrees per sec but low for 10 degrees per sec.
Our findings indicate that for a reliable and comparable measurement of spasticity, an exact description of test position and procedure is essential.
测量在两种不同髋关节位置时膝部屈肌和伸肌的痉挛程度。
瑞士诺特维尔瑞士截瘫中心。
对20例完全性脊髓损伤（SCI）患者，使用扭矩 - 速度测力计在以下位置进行测试：（1）仰卧位，髋关节角度为0度；（2）坐位，髋关节角度为90度。使用角度计测量两种位置时膝关节的活动范围。膝关节以每秒10度的速度进行两次屈伸运动。在相同轨迹上以每秒120度的速度再进行四次屈伸运动。在双腿运动过程中，以两种速度连续测量离心峰值扭矩。
在每秒120度的速度下，两种位置时腘绳肌和股四头肌的牵张反射存在显著差异（Wilcoxon配对t检验，P<0.05）。仰卧位时股四头肌的兴奋性高于坐位。对于腘绳肌，效果相反。在每秒10度的速度下，未发现坐位和仰卧位之间存在显著差异。每秒120度运动的重测信度高，但每秒10度运动的重测信度低。
我们的研究结果表明，为了可靠且可比地测量痉挛程度，准确描述测试位置和程序至关重要。
