Marusiak Jarosław, Jaskólska Anna, Koszewicz Magdalena, Budrewicz Sławomir, Jaskólski Artur
Department of Kinesiology, Faculty of Physiotherapy, University School of Physical Education, Al. I.J. Paderewskiego 35,Wroclaw, Poland.
Clin Biomech (Bristol). 2012 Jul;27(6):632-5. doi: 10.1016/j.clinbiomech.2012.02.001. Epub 2012 Feb 25.
Based on combined analysis of clinical assessment of parkinsonian rigidity (constant resistance force generated during passive movement in a joint), electromyography and/or dynamometry many studies showed objectively that anti-parkinsonian medication decreases the rigidity in Parkinson's disease (PD). Rigidity-related changes in resting muscle stiffness (changed muscle's mechanical property related to its structural changes and changed neural drive) in PD patients have been revealed by myometry, a simple, sensitive, and reliable method for measuring mechanical properties in human soft tissues. However, an application of myometry in estimation of medication effects on the PD rigidity-related muscle stiffness has not been reported yet. Therefore, our study aimed to assess medication-induced changes in resting muscle stiffness in PD patients using myometry.
We measured resting muscle stiffness by myometry and recorded a surface electromyogram of relaxed biceps brachii, brachioradialis and triceps brachii muscles in ten patients with PD (age: 51-80 years; Hoehn and Yahr stage: 2.5-4) during medication on-phase (when subjects felt best comfort and fitness after medication: Levodopa, Piribedil, Ropinirol) and medication off-phase (12h after withdrawal of the medication).
Our patients had significantly lower myometric stiffness and electromyogram amplitude in all tested muscles, and also lower clinical rigidity scores during the medication on-phase compared with the medication off-phase.
Myometry revealed that anti-parkinsonian medication decreases not only rigidity in PD, but also rigidity-related stiffness in resting skeletal muscles in PD patients. These findings show that myometry can enrich neurological practice, by allowing objective and reliable assessment of parkinsonian rigidity treatment effectiveness.
基于对帕金森病强直（关节被动运动时产生的恒定阻力）的临床评估、肌电图和/或肌力测定的综合分析，许多研究客观地表明，抗帕金森病药物可降低帕金森病（PD）的强直程度。通过肌动测量法，一种用于测量人体软组织力学特性的简单、灵敏且可靠的方法，已揭示了PD患者静息肌肉僵硬度（与肌肉结构变化和神经驱动改变相关的肌肉力学特性改变）与强直相关的变化。然而，尚未有关于肌动测量法在评估药物对PD强直相关肌肉僵硬度影响方面的应用报道。因此，我们的研究旨在使用肌动测量法评估药物引起的PD患者静息肌肉僵硬度变化。
我们通过肌动测量法测量静息肌肉僵硬度，并记录了10例PD患者（年龄：51 - 80岁；Hoehn和Yahr分期：2.5 - 4）在药物开启期（服用左旋多巴、吡贝地尔、罗匹尼罗后受试者感觉最舒适和健康时）和药物关闭期（停药12小时后）放松状态下肱二头肌、肱桡肌和肱三头肌的表面肌电图。
与药物关闭期相比，我们的患者在所有测试肌肉中肌动测量僵硬度和肌电图振幅均显著降低，且在药物开启期临床强直评分也更低。
肌动测量法显示，抗帕金森病药物不仅可降低PD患者的强直程度，还可降低其静息骨骼肌中与强直相关的僵硬度。这些发现表明，肌动测量法可通过客观、可靠地评估帕金森病强直治疗效果，丰富神经学实践。
