Bjerkefors Anna, Carpenter Mark G, Cresswell Andrew G, Thorstensson Alf
Biomechanics and Motor Control Laboratory, Department of Neuroscience, arolinska Institutet, and the Swedish School of Sport and Health Sciences (GIH), Box 5626, SE-11486 Stockholm, Sweden.
J Rehabil Med. 2009 Apr;41(5):390-2. doi: 10.2340/16501977-0336.
The aim of this study was to assess if, and how, upper body muscles are activated in a person with high thoracic spinal cord injury, clinically classified as complete, during maximal voluntary contractions and in response to balance perturbations.
Data from one person with spinal cord injury (T3 level) and one able-bodied person were recorded with electromyography from 4 abdominal muscles using indwelling fine-wire electrodes and from erector spinae and 3 upper trunk muscles with surface electrodes. Balance perturbations were carried out as forward or backward support surface translations.
The person with spinal cord injury was able to activate all trunk muscles, even those below the injury level, both in voluntary efforts and in reaction to balance perturbations. Trunk movements were qualitatively similar in both participants, but the pattern and timing of muscle responses differed: upper trunk muscle involvement and occurrence of co-activation of ventral and dorsal muscles were more frequent in the person with spinal cord injury.
These findings prompt further investigation into trunk muscle function in paraplegics, and highlight the importance of including motor tests for trunk muscles in persons with thoracic spinal cord injury, in relation to injury classification, prognosis and rehabilitation.
本研究旨在评估在最大自主收缩期间以及对平衡扰动做出反应时,临床上分类为完全性的高位胸段脊髓损伤患者的上身肌肉是否以及如何被激活。
使用植入式细线电极从4块腹部肌肉以及使用表面电极从竖脊肌和3块上躯干肌肉记录一名脊髓损伤患者(T3水平)和一名健全人的肌电图数据。通过向前或向后移动支撑表面来进行平衡扰动。
脊髓损伤患者能够在自主用力以及对平衡扰动做出反应时激活所有躯干肌肉,甚至是损伤水平以下的肌肉。两名参与者的躯干运动在质量上相似,但肌肉反应的模式和时间不同:脊髓损伤患者上躯干肌肉的参与以及腹侧和背侧肌肉共同激活的发生更为频繁。
这些发现促使对截瘫患者的躯干肌肉功能进行进一步研究,并强调在胸段脊髓损伤患者中纳入躯干肌肉运动测试对于损伤分类、预后和康复的重要性。