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重力补偿对中风患者手臂运动不同时间阶段肌肉激活模式的影响。

Influence of gravity compensation on muscle activation patterns during different temporal phases of arm movements of stroke patients.

作者信息

Prange G B, Jannink M J A, Stienen A H A, van der Kooij H, Ijzerman M J, Hermens H J

机构信息

Roessingh Research and Development, Enschede, the Netherlands.

出版信息

Neurorehabil Neural Repair. 2009 Jun;23(5):478-85. doi: 10.1177/1545968308328720. Epub 2009 Feb 3.

Abstract

BACKGROUND

Arm support to help compensate for the effects of gravity may improve functional use of the shoulder and elbow during therapy after stroke, but gravity compensation may alter motor control.

OBJECTIVE

To obtain quantitative information on how gravity compensation influences muscle activation patterns during functional, 3-dimensional reaching movements.

METHODS

Eight patients with mild hemiparesis performed 2 sets of repeated reach and retrieval movements, with and without unloading the arm, using a device that acted at the elbow and forearm to compensate for gravity. Electromyographic (EMG) patterns of 6 upper extremity muscles were compared during elbow and shoulder joint excursions with and without gravity compensation.

RESULTS

Movement performance was similar with and without gravity compensation. Smooth rectified EMG (SRE) values were decreased from 25% to 50% during movements with gravity compensation in 5 out of 6 muscles. The variation of SRE values across movement phases did not differ across conditions.

CONCLUSIONS

Gravity compensation did not affect general patterns of muscle activation in this sample of stroke patients, probably since they had adequate function to complete the task without arm support. Gravity compensation did facilitate active arm movement excursions without impairing motor control. Gravity compensation may be a valuable modality in conventional or robot-aided therapy to increase the intensity of training for mildly impaired patients.

摘要

背景

手臂支撑以帮助抵消重力影响,可能会改善中风后治疗期间肩部和肘部的功能使用,但重力补偿可能会改变运动控制。

目的

获取关于重力补偿如何影响功能性三维伸手动作期间肌肉激活模式的定量信息。

方法

八名轻度偏瘫患者使用一种作用于肘部和前臂以补偿重力的装置,进行两组重复的伸手和取物动作,一组是手臂不卸载重力,另一组是卸载重力。比较了在有和没有重力补偿的情况下,6块上肢肌肉在肘关节和肩关节活动期间的肌电图(EMG)模式。

结果

有无重力补偿时的运动表现相似。6块肌肉中有5块在有重力补偿的运动过程中,平滑整流肌电图(SRE)值从25%降至50%。不同条件下SRE值在运动阶段的变化没有差异。

结论

重力补偿并未影响该中风患者样本中的肌肉激活总体模式,可能是因为他们有足够的功能在没有手臂支撑的情况下完成任务。重力补偿确实促进了主动手臂运动幅度,而不损害运动控制。重力补偿可能是传统或机器人辅助治疗中的一种有价值的方式,可增加对轻度受损患者的训练强度。

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