Tremblay F, Malouin F, Richards C L, Dumas F
Neurobiology Laboratory, Faculty of Medicine, Laval University, Québec, Canada.
Scand J Rehabil Med. 1990;22(4):171-80.
We studied the short term effects of a single session of prolonged muscle stretch (PMS) on reflex and voluntary muscle activations in 22 children with spastic cerebral palsy (CP) assigned to an experimental (n = 12) and a control group (n = 10). Children of the experimental group underwent PMS of the triceps surae (TS) by standing with the feet dorsiflexed on a tilt-table for 30 min, whereas children of the control group were kept at rest. The effects were determined by measuring the associated changes in torque and in electromyographic (EMG) activity of the TS and tibialis anterior (TA) muscles during both passive ankle movements and maximal static voluntary contractions. The results indicate that PMS led to reduced spasticity in ankle muscles as demonstrated by the significant reductions (p less than 0.05) of the neuromuscular responses (torque and EMG) to passive movement. These inhibitory effects lasted up to 35 min after cessation of PMS. In addition, the capacity to voluntarily activate the plantar flexors was significantly (p less than 0.05) increased post-PMS, but the capacity to activate the dorsiflexors was apparently not affected. These findings suggest that repeated sessions of PMS may have beneficial effects in the management of spasticity in children with CP.
我们研究了单次长时间肌肉拉伸（PMS）对22名痉挛型脑瘫（CP）儿童反射性和自主性肌肉激活的短期影响，这些儿童被分为实验组（n = 12）和对照组（n = 10）。实验组儿童通过在倾斜台上背屈脚站立30分钟来接受腓肠肌（TS）的PMS，而对照组儿童则保持休息状态。通过测量被动踝关节运动和最大静态自主收缩期间TS和胫前肌（TA）肌肉的扭矩和肌电图（EMG）活动的相关变化来确定效果。结果表明，PMS导致踝关节肌肉痉挛减轻，这表现为对被动运动的神经肌肉反应（扭矩和EMG）显著降低（p小于0.05）。这些抑制作用在PMS停止后持续长达35分钟。此外，PMS后自主激活跖屈肌的能力显著增加（p小于0.05），但激活背屈肌的能力显然未受影响。这些发现表明，重复进行PMS可能对CP儿童痉挛的管理具有有益效果。
