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持续被动运动对逆转慢性脊髓损伤患者适应的脊髓回路的影响。

Effects of continuous passive motion on reversing the adapted spinal circuit in humans with chronic spinal cord injury.

机构信息

Department of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan.

出版信息

Arch Phys Med Rehabil. 2013 May;94(5):822-8. doi: 10.1016/j.apmr.2012.11.035. Epub 2012 Dec 3.

Abstract

OBJECTIVE

To investigate the possibility of restoring the adapted spinal circuit after spinal cord injury (SCI) by means of long-term continuous passive motion (CPM) of the ankle joint.

DESIGN

Randomized controlled trial with repeated measures.

SETTING

Research laboratory in a general hospital.

PARTICIPANTS

Individuals with motor complete SCI (N=14) were recruited from a community.

INTERVENTION

CPM of the ankle joint for 1 hour a day, 5 days a week for 4 weeks.

MAIN OUTCOME MEASURES

Modified Ashworth Scale (MAS) scores for evaluation of spasticity and postactivation depression (PAD) were documented prior to and after intervention.

RESULTS

MAS scores improved after 4 weeks of CPM intervention, indicating a reduction in spasticity of the ankle joint. PAD was restored after 4 weeks of training.

CONCLUSIONS

Passive motion of the ankle joint alone was sufficient in reversing the adapted spinal circuit, and therefore indicates that spasticity after SCI could possibly be managed by CPM intervention. The results of this study support the use of the passive mode of robot-assisted therapy for humans with complete SCI who cannot exercise actively.

摘要

目的

通过踝关节长期持续被动运动(CPM)来探索脊髓损伤(SCI)后恢复适应性脊髓回路的可能性。

设计

随机对照试验,重复测量。

地点

综合医院的研究实验室。

参与者

从社区招募运动完全性 SCI 个体(N=14)。

干预措施

每天 1 小时,每周 5 天,共 4 周的踝关节 CPM。

主要观察指标

改良 Ashworth 量表(MAS)评分用于评估痉挛和后激活抑制(PAD),在干预前后进行记录。

结果

CPM 干预 4 周后 MAS 评分改善,表明踝关节痉挛减轻。经过 4 周的训练后 PAD 得到恢复。

结论

单独的踝关节被动运动足以逆转适应性脊髓回路,因此表明 SCI 后的痉挛可以通过 CPM 干预来管理。本研究结果支持对无法主动运动的完全性 SCI 患者使用机器人辅助治疗的被动模式。

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