Mange K C, Ditunno J F, Herbison G J, Jaweed M M
Department of Rehabilitation Medicine, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA 19107.
Arch Phys Med Rehabil. 1990 Jul;71(8):562-5.
This study compared the time of recovery at the zone of injury between motor complete (Frankel A and B) and motor incomplete (Frankel C and D) cervical spinal cord injured patients for the biceps (C5), extensor carpi radialis (C6), and triceps (C7) muscles. Manual muscle testing was performed initially three to seven days postinjury, then weekly for four weeks, and then monthly for six months. Subjects between the ages of 15 and 70 years with C4, C5, C6, or C7 neurologic levels were classified according to whether their selected muscle was greater than 0/5 and less than 3/5 grade (n = 32) or greater than or equal to 3/5 grade (n = 28) at initial evaluation. Subjects were further classified based on their Frankel score. Motor incomplete patients with muscle strength less than 3/5 had an average time of recovery to grade 3/5 of 0.9 months (median = 2 weeks), and all seven patients achieved grade 3/5 by two months postinjury. Motor complete patients had an average time of recovery to grade 3/5 of 1.8 months (median = 2 months), and 18 of 25 patients achieved grade 3/5 by two months postinjury (p = 0.1). For muscles greater than or equal to 3/5, motor incomplete subjects had an average time for improvement of one full grade of 1.5 months (median = 2 months), and motor complete subjects had an average time for improvement of one grade of 2.3 months (median = 1 month, p = 0.1).(ABSTRACT TRUNCATED AT 250 WORDS)
本研究比较了运动完全性(Frankel A和B级)和运动不完全性(Frankel C和D级)颈脊髓损伤患者肱二头肌(C5)、桡侧腕伸肌(C6)和肱三头肌(C7)损伤区域的恢复时间。损伤后最初3至7天进行徒手肌力测试,然后连续四周每周测试一次,之后六个月每月测试一次。年龄在15至70岁之间、神经损伤平面为C4、C5、C6或C7的受试者,根据初次评估时所选肌肉肌力是否大于0/5且小于3/5级(n = 32)或大于或等于3/5级(n = 28)进行分类。受试者进一步根据Frankel评分进行分类。肌力小于3/5的运动不完全性患者恢复至3/5级的平均时间为0.9个月(中位数 = 2周),所有7例患者在损伤后两个月时达到3/5级。运动完全性患者恢复至3/5级的平均时间为1.8个月(中位数 = 2个月),25例患者中有18例在损伤后两个月时达到3/5级(p = 0.1)。对于肌力大于或等于3/5的肌肉,运动不完全性受试者提高一个完整级别的平均时间为1.5个月(中位数 = 2个月),运动完全性受试者提高一个级别的平均时间为2.3个月(中位数 = 1个月,p = 0.1)。(摘要截断于250字)