Saarinen J, Lehtonen K, Mälkiä E, Lahdenne P
Department of Physiotherapy, Hospital for Children and Adolescents, HUCH, Helsinki, Finland.
Clin Exp Rheumatol. 2008 Sep-Oct;26(5):947-53.
The aim of this study was to measure lower extremity isometric strength in patients with juvenile idiopathic arthritis (JIA) and to evaluate the usefulness of an adjustable dynamometer chair in the clinical work.
Twenty-five children with JIA and 25 healthy, age-matched controls, aged 7-12 (mean age 10.1) were studied. The isometric maximal strength of knee and ankle muscles was measured on both sides using the dynamometer chair. Before and after the measurements the Children's Effort Rating Table (CERT) was used to assess physical effort and feelings of exertion during the measurements.
In all the tested muscle groups, there was a trend towards lower muscle strength values in the patients with JIA but significant differences were found only in knee extension (at 80 degrees knee angle) on both sides and in ankle plantarflexion if both ankles had had arthritis. No difference was observed in perceived exertion between patients and controls, but both groups significantly sensed the exertion after the muscle strength measurement (mean exertion before, JIA/control 2.2/2.0, and after 5.9/5.8).
Isometric muscle strength in children with JIA can be close to normal when the disease is not active. However, especially in knee extensors and ankle plantarflexors, muscle weakness may occur. From technical standpoint, an adjustable dynamometer chair can be used for assessment of isometric maximal strength in children with JIA.
本研究旨在测量幼年特发性关节炎(JIA)患者的下肢等长肌力,并评估可调节测力计椅在临床工作中的实用性。
对25名患有JIA的儿童和25名年龄匹配的健康对照儿童进行研究,年龄在7至12岁之间(平均年龄10.1岁)。使用测力计椅测量双侧膝关节和踝关节肌肉的等长最大肌力。在测量前后,使用儿童努力评级表(CERT)评估测量过程中的体力消耗和用力感受。
在所有测试的肌肉群中,JIA患者的肌肉力量值有降低的趋势,但仅在双侧膝关节伸展(膝关节角度为80度时)以及双侧踝关节均患有关节炎时的踝关节跖屈方面发现了显著差异。患者和对照组在用力感受方面未观察到差异,但两组在肌肉力量测量后均明显感觉到了用力(测量前的平均用力程度,JIA组/对照组为2.2/2.0,测量后为5.9/5.8)。
当疾病不活跃时,JIA儿童的等长肌力可能接近正常。然而,尤其是在膝关节伸肌和踝关节跖屈肌中,可能会出现肌肉无力。从技术角度来看,可调节测力计椅可用于评估JIA儿童的等长最大肌力。