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慢性脊髓损伤不完全性而非完全性患者比目鱼肌的牵张反射兴奋性增强。

Enhanced stretch reflex excitability of the soleus muscle in persons with incomplete rather than complete chronic spinal cord injury.

作者信息

Nakazawa Kimitaka, Kawashima Noritaka, Akai Masami

机构信息

Department of Movement Functions, Research Institute, National Rehabilitation Center for Persons with Disabilities, Saitama, Japan.

出版信息

Arch Phys Med Rehabil. 2006 Jan;87(1):71-5. doi: 10.1016/j.apmr.2005.08.122.

Abstract

OBJECTIVE

To compare excitabilities of spinal stretch reflex among clinically complete spinal cord injury (SCI), incomplete SCI, elderly healthy, and young healthy subjects.

DESIGN

Case comparison.

SETTING

Research laboratory.

PARTICIPANTS

Volunteer sample of 12 complete SCI, 10 incomplete SCI, 10 elderly, and 11 young subjects.

INTERVENTION

Mechanically induced stretch reflex, H-reflex, and M response in electromyographic activity of the soleus muscle were recorded in all subjects.

MAIN OUTCOME MEASURES

Absolute peak-to-peak stretch reflex amplitude and maximum H-reflex (Hmax), and those values relative to the maximum M response (Mmax) amplitude (relative peak-to-peak stretch reflex amplitude) and H/M ratio.

RESULTS

Both the absolute and relative peak-to-peak stretch reflex amplitudes showed the greatest values in incomplete SCI among the 4 groups. Although absolute and relative peak-to-peak stretch reflex amplitudes of the incomplete SCI group were greater than those of the complete SCI group, the H/M ratios of both groups were comparable, and were greater than those of the younger and elderly groups.

CONCLUSIONS

The results suggest that the greater absolute and relative peak-to-peak stretch reflex amplitudes of incomplete SCI were mostly due to the greater maximum motor potential (Mmax), while the elevated spinal motoneuronal excitability shown by the increased H/M ratio was maintained in the chronic stage after both complete and incomplete SCIs.

摘要

目的

比较临床完全性脊髓损伤(SCI)、不完全性SCI、老年健康受试者和年轻健康受试者的脊髓牵张反射兴奋性。

设计

病例对照研究。

地点

研究实验室。

参与者

12例完全性SCI、10例不完全性SCI、10例老年人和11例年轻人的志愿者样本。

干预措施

记录所有受试者比目鱼肌肌电图活动中的机械诱导牵张反射、H反射和M反应。

主要观察指标

绝对峰峰值牵张反射幅度和最大H反射(Hmax),以及相对于最大M反应(Mmax)幅度的那些值(相对峰峰值牵张反射幅度)和H/M比值。

结果

在这4组中,绝对和相对峰峰值牵张反射幅度在不完全性SCI组中显示出最大值。虽然不完全性SCI组的绝对和相对峰峰值牵张反射幅度大于完全性SCI组,但两组的H/M比值相当,且大于年轻组和老年组。

结论

结果表明,不完全性SCI较大的绝对和相对峰峰值牵张反射幅度主要归因于较大的最大运动电位(Mmax),而完全性和不完全性SCI后慢性期H/M比值升高所显示的脊髓运动神经元兴奋性升高得以维持。

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