Fosang Adrienne, Baker Richard
Hugh Williamson Gait Analysis Laboratory, Royal Children's Hospital, Melbourne, Australia.
Gait Posture. 2006 Dec;24(4):406-11. doi: 10.1016/j.gaitpost.2005.09.015. Epub 2006 Jan 18.
This paper describes a protocol for dynamometer assisted manual muscle testing of the major muscle groups of the lower extremity and its application to 11 able-bodied children who also had conventional gait analysis to obtain joint kinetics. Data from the manual muscle testing was processed in such a way that the results for maximum muscle strength (grade 5) and resistance against gravity alone (grade 3) were presented in Nm/kg allowing direct comparison with conventional joint kinetics. The strength measurements of the hip muscles and the knee extensors were between two and three times the moments exerted during normal walking. Those of the knee flexors and dorsiflexors were about five times the joint moments. Measured plantarflexor strength was only just greater than the moment exerted during walking. These results, particularly those for the plantarflexors, question how valid it is to use measures of isometric muscle strength as indicators of muscle function during activity. The study also compares grade 3 muscle strength with both grade 5 strength and the maximum joint moments. For all muscle groups tested grade 3 muscle strength was less than the maximum moment exerted during normal walking. For the plantarflexors it was less than 1% of that moment. The study demonstrates that reliable isometric muscle testing is possible in able-bodied children but requires considerable care and is time consuming. More work is required to understand how measurements made in this way relate to how muscles function during activity.
本文描述了一种用于下肢主要肌肉群的测力计辅助手动肌力测试方案，以及该方案在11名身体健全儿童中的应用，这些儿童还接受了传统步态分析以获取关节动力学数据。对手动肌力测试数据进行处理，使得最大肌肉力量（5级）和仅抗重力（3级）的测试结果以牛顿米每千克为单位呈现，以便与传统关节动力学进行直接比较。髋部肌肉和膝关节伸肌的力量测量值是正常行走时所施加力矩的两到三倍。膝关节屈肌和背屈肌的力量测量值约为关节力矩的五倍。测得的跖屈肌力量仅略大于行走时所施加的力矩。这些结果，尤其是跖屈肌的结果，让人质疑将等长肌肉力量测量值用作活动期间肌肉功能指标的有效性。该研究还将3级肌肉力量与5级力量以及最大关节力矩进行了比较。对于所有测试的肌肉群，3级肌肉力量均小于正常行走时所施加的最大力矩。对于跖屈肌，该力量小于该力矩的1%。该研究表明，在身体健全的儿童中进行可靠对等长肌肉测试是可行的，但需要格外小心且耗时较长。需要开展更多工作来了解以这种方式进行的测量与肌肉在活动期间的功能之间的关系。
