Department of Physical Therapy, Miller School of Medicine, University of Miami, Coral Gables, FL, USA.
Restor Neurol Neurosci. 2013;31(5):633-46. doi: 10.3233/RNN-120255.
Sparse data exist about effects of locomotor training on spasticity in individuals with spinal cord injury (SCI). We investigated changes in spastic responses in individuals with motor-incomplete SCI (MISCI) associated with locomotor training and examined properties of a biomechanical measure of clonus severity, plantar flexor reflex threshold angle (PF RTA).
In 18 individuals with chronic MISCI, we assessed biomechanical and electrophysiologic measures of extensor spasticity and their relationship with walking speed before and after 12 weeks of body-weight supported locomotor training. Measures included PF RTA, plantar flexor (ankle clonus) and quadriceps spasm duration, soleus H-reflex, and ankle muscle electromyography. PF RTA validity was assessed by measuring PF RTA and clonus duration in 40 individuals with SCI and 10 non-disabled individuals.
Locomotor training was associated with decreased PF RTA (p = 0.06), ankle clonus (p = 0.09) and quadriceps spasm (p = 0.05). PF RTA discriminated between non-disabled individuals and individuals with SCI and was moderately correlated with walking speed, soleus H/M ratio, and quadriceps spasm duration.
In persons with spastic paresis due to MISCI, locomotor training was associated with decreased spasticity as measured by decreased plantar flexor excitability, ankle clonus, and quadriceps spasm.
关于运动训练对脊髓损伤（SCI）患者痉挛的影响，相关稀疏数据有限。我们研究了运动不完全性 SCI（MISCI）患者与运动训练相关的痉挛反应变化，并检验了跟腱反射阈角度（PF RTA）这一生物力学痉挛严重程度测量指标的特性。
在 18 名慢性 MISCI 患者中，我们在 12 周的减重支持步行训练前后评估了伸肌痉挛的生物力学和电生理测量指标及其与步行速度的关系。测量指标包括 PF RTA、跟腱反射（踝阵挛）和股四头肌痉挛持续时间、比目鱼肌 H 反射和踝部肌肉肌电图。通过在 40 名 SCI 患者和 10 名非残疾个体中测量 PF RTA 和踝阵挛持续时间，评估了 PF RTA 的有效性。
运动训练与 PF RTA（p=0.06）、踝阵挛（p=0.09）和股四头肌痉挛（p=0.05）降低有关。PF RTA 可区分非残疾个体和 SCI 患者，且与步行速度、比目鱼肌 H/M 比值和股四头肌痉挛持续时间中度相关。
在 MISCI 导致的痉挛性轻瘫患者中，运动训练与降低的跟腱反射兴奋性、踝阵挛和股四头肌痉挛有关，这表明运动训练可降低痉挛程度。
