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急性中风后个体患侧腿部的力量与协调性

Strength and coordination in the paretic leg of individuals following acute stroke.

作者信息

Hidler Joseph M, Carroll Marti, Federovich Elissa H

机构信息

Biomedical Engineering Department, Catholic University, Washington, DC 20064, USA.

出版信息

IEEE Trans Neural Syst Rehabil Eng. 2007 Dec;15(4):526-34. doi: 10.1109/TNSRE.2007.907689.

Abstract

The goal of this study was to determine whether acute stroke survivors demonstrate abnormal synergy patterns in their affected lower extremity. During maximum isometric contractions with subjects in a standing position, joint torques generated simultaneously at the knee and hip were measured, along with associated muscle activation patterns in eight lower limb muscles. Ten acute stroke survivors and nine age-match controls participated in the study. For all joints tested, stroke subjects demonstrated significantly less maximum isometric torque than age-matched control subjects. However, the synergistic torques generated in directions different than the direction that was being maximized were not significantly different between the two groups. According to electromyography (EMG) data, it was found that stroke subjects activated antagonistic muscle groups significantly higher than the control group subjects, suggesting that deficits in joint torque may be at least partially attributable to co-contraction of antagonistic muscles. Our findings suggest that a primary contributor to lower limb motor impairment in acute hemiparetic stroke is poor volitional torque generating capacity, which is at least partially attributable to co-contraction of antagonistic muscles. Furthermore, while we did not observe abnormal torque synergy patterns commonly found in the upper limbs, muscle activation patterns differed between groups for many of the directions tested indicating changes in the motor control strategies of acute stroke survivors.

摘要

本研究的目的是确定急性中风幸存者患侧下肢是否表现出异常的协同运动模式。让受试者站立进行最大等长收缩时,测量膝关节和髋关节同时产生的关节扭矩,以及八块下肢肌肉的相关肌肉激活模式。十名急性中风幸存者和九名年龄匹配的对照组参与了该研究。对于所有测试关节,中风受试者表现出的最大等长扭矩明显低于年龄匹配的对照组受试者。然而,两组之间在与最大扭矩方向不同的方向上产生的协同扭矩没有显著差异。根据肌电图(EMG)数据发现,中风受试者拮抗肌群的激活明显高于对照组受试者,这表明关节扭矩不足可能至少部分归因于拮抗肌的共同收缩。我们的研究结果表明,急性偏瘫性中风患者下肢运动障碍的主要原因是意志性扭矩产生能力差,这至少部分归因于拮抗肌的共同收缩。此外,虽然我们没有观察到上肢常见的异常扭矩协同模式,但在许多测试方向上,两组之间的肌肉激活模式不同,这表明急性中风幸存者的运动控制策略发生了变化。

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