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手法牵伸:对患有痉挛性外在指屈肌的中风患者手指运动控制和力量控制的影响

Manual stretch: effect on finger movement control and force control in stroke subjects with spastic extrinsic finger flexor muscles.

作者信息

Carey J R

机构信息

Department of Physical Medicine, University of Minnesota, Minneapolis.

出版信息

Arch Phys Med Rehabil. 1990 Oct;71(11):888-94.

PMID:2222157
Abstract

This study evaluated the effects of manual stretch of extrinsic finger flexor muscles on finger extension movement control and force control in 16 spastic hemiparetic subjects. These subjects were randomly divided into a control group and an experimental group. A group of able-bodied subjects also participated. A joint-movement tracking test (JMTT) quantified control of active finger extension movement at the metacarpophalangeal joint of the index finger within the available range of active movement, and a force tracking test (FTT) quantified control of isometric finger extension force at the same joint within the subject's available force range. Electromyographic activity was monitored in the extensor digitorum and flexor digitorum superficialis muscles during both tracking tests. Manual stretch was applied to the extrinsic finger flexor muscles of the experimental group between the pretest and posttest tracking tests. The JMTT performances of both control (p less than .025) and experimental (p less than .05) groups were significantly subnormal on the pretest as were FTT performances of controls (p less than .01) and study subjects (p less than .03). The JMTT improvement on posttest was significantly greater (p less than .05) in subjects than in controls. However, the change in FTT performance was not significantly different between the two groups. Manual stretch treatment, properly applied to extrinsic finger flexor muscles, is an effective method of temporarily improving the control of finger extension movement in spastic hemiparetic subjects.

摘要

本研究评估了对16名痉挛性偏瘫患者的外在手指屈肌进行手法拉伸,对其手指伸展运动控制和力量控制的影响。这些患者被随机分为对照组和实验组。一组健康受试者也参与了研究。关节运动跟踪测试(JMTT)量化了食指掌指关节在主动运动可用范围内主动手指伸展运动的控制情况,力量跟踪测试(FTT)量化了同一关节在受试者可用力量范围内等长手指伸展力的控制情况。在两项跟踪测试过程中,对示指伸肌和指浅屈肌的肌电活动进行了监测。在预测试和后测试跟踪测试之间,对实验组的外在手指屈肌进行手法拉伸。对照组(p<0.025)和实验组(p<0.05)在预测试时的JMTT表现均显著低于正常水平,对照组(p<0.01)和研究对象(p<0.03)的FTT表现也是如此。受试者在后测试时JMTT的改善显著大于对照组(p<0.05)。然而,两组之间FTT表现的变化没有显著差异。对外在手指屈肌进行适当的手法拉伸治疗,是暂时改善痉挛性偏瘫患者手指伸展运动控制的有效方法。

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