Gray Vicki, Rice Charles L, Garland S Jayne
Graduate Program in Health and Rehabilitation Science.
Physiother Can. 2012 Fall;64(4):415-26. doi: 10.3138/ptc.2011-03.
To provide a comprehensive review of changes that occur in the muscle after stroke and how these changes influence the force-generating capacity of the muscle.
A literature search of PubMed, CINAHL, MEDLINE, and Embase was conducted using the search terms stroke, hemiparesis, muscle structure, cross sectional area, atrophy, force, velocity, and torque. There were 27 articles included in this review.
Three changes occur in the muscle after stroke: a decrease in muscle mass, a decrease in fibre length, and a smaller pennation angle. In addition, the tendon is stretched and becomes more compliant. All of these factors reduce the affected muscle's ability to generate forces similar to controls or to non-paretic muscles. The result is a leftward shift in the length-tension curve, a downward shift in the torque-angle curve, and a downward shift in the force-velocity curve.
Changes in muscle architecture contributing to weakness, such as muscle-fibre length, pennation angle, muscle atrophy, and tendon compliance, should be prevented or reversed by means of an appropriate rehabilitation programme.
全面综述中风后肌肉发生的变化，以及这些变化如何影响肌肉的力量生成能力。
使用搜索词“中风”“偏瘫”“肌肉结构”“横截面积”“萎缩”“力量”“速度”和“扭矩”，对PubMed、CINAHL、MEDLINE和Embase进行文献检索。本综述纳入了27篇文章。
中风后肌肉会出现三种变化：肌肉质量下降、纤维长度缩短和羽状角变小。此外，肌腱会被拉伸并变得更具顺应性。所有这些因素都会降低患侧肌肉产生与对照组或非瘫痪侧肌肉相似力量的能力。结果是长度-张力曲线向左移位，扭矩-角度曲线向下移位，力量-速度曲线向下移位。
应通过适当的康复计划预防或逆转导致肌肉无力的肌肉结构变化，如肌纤维长度、羽状角、肌肉萎缩和肌腱顺应性等。
