对偏瘫性中风幸存者痉挛肌肉被动特性的评估。
An evaluation of passive properties of spastic muscles in hemiparetic stroke survivors.
作者信息
Chardon Matthieu K, Suresh Nina L, Rymer William Z
机构信息
Biomedical Engineering, Northwestern University, Evanston, IL, USA.
出版信息
Annu Int Conf IEEE Eng Med Biol Soc. 2010;2010:2993-6. doi: 10.1109/IEMBS.2010.5626155.
We have reported earlier [1] a new method for estimating reflex threshold in spastic muscles of stroke survivors, using controlled amplitude taps superimposed on progressive and controlled muscle indentation of the bicipital tendon in the bicipital fossa. This muscle indentation is done with a linear actuator positioned over the biceps muscle tendon at the elbow. In the course of testing for increased stretch reflex responses, (a cardinal feature of spasticity), we have also observed that the intrinsic or passive stiffness of the muscle is often increased. This assessment is derived from recordings of the force generated by the tendon during progressive loading, and by the instantaneous force response to the tendon tap. Thus, it appears that passive properties of muscle are often also changed in parallel with the reflex abnormalities. While some of these mechanical features have been described in earlier studies of torque-angle relations of spastic joints, it appears that these features can also be recognized readily using a small actuator that loads the tendon progressively. These findings may help clinicians recognize early changes in muscle mechanical properties, and may help them prevent large-scale adverse changes in muscle function.
我们之前曾报道过一种新方法[1],用于评估中风幸存者痉挛肌肉的反射阈值,该方法是在肱二头肌窝内对肱二头肌肌腱进行渐进性和控制性肌肉压痕的同时,叠加控制性幅度的轻叩。这种肌肉压痕是通过置于肘部肱二头肌肌腱上方的线性致动器完成的。在测试伸展反射反应增强(痉挛的一个主要特征)的过程中,我们还观察到肌肉的固有或被动僵硬度常常增加。这种评估来自于在渐进性加载过程中肌腱产生的力的记录,以及对肌腱轻叩的即时力响应。因此,肌肉的被动特性似乎也常常与反射异常同时发生改变。虽然在早期关于痉挛关节扭矩 - 角度关系的研究中已经描述了其中一些力学特征,但似乎使用一个对肌腱进行渐进性加载的小型致动器也能很容易地识别这些特征。这些发现可能有助于临床医生识别肌肉力学特性的早期变化,并可能帮助他们预防肌肉功能的大规模不良变化。