Chang Ya-Ju, Fang Chia-Ying, Hsu Miao-Ju, Lien Hen-Yu, Wong Mei-Kwan
Physical Therapy Department and Graduate Institute of Rehabilitation Science, Chang Gung University, Tao-Yuan, Taiwan.
Clin Rehabil. 2007 Aug;21(8):712-8. doi: 10.1177/0269215507079137.
To examine the effect of ankle continuous passive motion on the reflex excitability and overall hypertonia of calf muscles in individuals with chronic spinal cord injury and without physical disabilities.
Two-way repeated measure experimental design.
Inpatient rehabilitation department in general hospital.
The spinal cord injury group comprised eight individuals with chronic complete spinal cord injury and the control group comprised eight healthy people without physical disabilities. An additional eight healthy people were recruited as the sham group.
Each subject received 60 min of continuous passive motion on the ankle joint.
The H-reflex of the soleus muscle was elicited by tibia nerve stimulation just before, immediately after, and 10 min after continuous passive motion. The Modified Ashworth Scale (MAS) score at the ankle joint was recorded for the spinal cord injury group just before and 10 min after continuous passive motion therapy. RESULTS. After 60 min of continuous passive motion of the ankle joint, the H-reflex amplitude at the soleus muscle was depressed in individuals with and without spinal cord injury (77.46 +/- 32.64%, P = 0.047 and 51.76 +/- 26.74% of initial, P<0.0001, respectively). This depression persisted up to 10 min after continuous passive motion only in individuals without spinal cord injury. In individuals with spinal cord injury, the median of MAS scores decreased from 2 to 1.25 after continuous passive motion.
Sixty minutes of continuous passive motion of the ankle joint decreased reflex excitability and overall hypertonia in people with or without spinal cord injury. The depression of overall hypertonia persisted longer than the reflex excitability in people with spinal cord injury.
研究踝关节持续被动运动对慢性脊髓损伤且无身体残疾个体小腿肌肉反射兴奋性和整体肌张力亢进的影响。
双向重复测量实验设计。
综合医院住院康复科。
脊髓损伤组包括8名慢性完全性脊髓损伤患者，对照组包括8名无身体残疾的健康人。另外招募8名健康人作为假手术组。
每位受试者接受60分钟的踝关节持续被动运动。
在持续被动运动前、运动刚结束时以及运动后10分钟，通过刺激胫神经引出比目鱼肌的H反射。记录脊髓损伤组在持续被动运动治疗前和运动后10分钟时踝关节的改良Ashworth量表（MAS）评分。结果：踝关节持续被动运动60分钟后，脊髓损伤患者和非脊髓损伤患者比目鱼肌的H反射波幅均降低（分别为初始值的77.46±32.64%，P = 0.047；以及51.76±26.74%，P<0.0001）。这种降低仅在非脊髓损伤个体中持续到持续被动运动后10分钟。在脊髓损伤个体中，持续被动运动后MAS评分中位数从2降至1.25。
60分钟的踝关节持续被动运动可降低脊髓损伤或未损伤个体的反射兴奋性和整体肌张力亢进。在脊髓损伤个体中，整体肌张力亢进的降低持续时间比反射兴奋性更长。
