Condliffe Elizabeth G, Clark David J, Patten Carolynn
Neural Control of Movement Laboratory, Department of Rehabilitation Sciences, Boston University, Boston, MA, USA.
Clin Neurophysiol. 2005 Aug;116(8):1870-8. doi: 10.1016/j.clinph.2005.02.030.
To establish reliability of quantitative measures of elbow joint spastic hypertonia in post-stroke hemiparesis.
Nine subjects with post-stroke hemiparesis (mn duration: 42 months) were tested on three separate days. Biceps brachii and brachioradialis EMG were recorded during passive ramp-and-hold extensions applied at seven speeds between 30 and 210 degrees /s. EMG burst duration, onset position threshold, and burst intensity were used to evaluate reflex activity. Torque at 40 degrees of elbow flexion was used as a mechanical indicator of spastic hypertonia.
Across speeds ICCs were consistent, means ranged between 0.63 and 0.85. Thus, relative reliability was fair to excellent for all parameters. Absolute reliability, determined using standard error of measurement expressed as a percentage of the mean score (%SEM), improved at higher speeds (> or = 120 degrees/s).
These results establish reliability of reflex and mechanical measures of elbow spastic hypertonia post-stroke. The data demonstrate greater reflex detection at high speeds, indicating greater potential to document meaningful changes in these distinct aspects of spastic hypertonia following intervention.
Based on findings of this study, reliability was demonstrated using four parameters of reflex EMG and torque indicating measurement consistency across sessions. These observations motivate determination of requisite effect sizes for clinical trials that evaluate treatment outcome.
建立中风后偏瘫患者肘关节痉挛性肌张力亢进定量测量的可靠性。
对9名中风后偏瘫患者（平均病程：42个月）在三个不同日期进行测试。在30至210度/秒之间的七种速度下进行被动斜坡保持伸展时，记录肱二头肌和肱桡肌的肌电图。肌电图爆发持续时间、起始位置阈值和爆发强度用于评估反射活动。肘关节屈曲40度时的扭矩用作痉挛性肌张力亢进的力学指标。
在不同速度下，组内相关系数（ICCs）一致，均值在0.63至0.85之间。因此，所有参数的相对可靠性为中等至优秀。使用测量标准误差表示为平均得分百分比（%SEM）来确定的绝对可靠性，在较高速度（≥120度/秒）时有所提高。
这些结果建立了中风后肘关节痉挛性肌张力亢进反射和力学测量的可靠性。数据表明在高速时反射检测能力更强，这表明在干预后记录痉挛性肌张力亢进这些不同方面有意义变化的潜力更大。
基于本研究的结果，使用反射肌电图和扭矩的四个参数证明了可靠性，表明各次测量之间具有一致性。这些观察结果促使确定评估治疗效果的临床试验所需的效应大小。
