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痉挛特定症状对亚急性和慢性脊髓损伤期间下肢随意肌功能、步态和日常活动的影响。

Impact of specific symptoms of spasticity on voluntary lower limb muscle function, gait and daily activities during subacute and chronic spinal cord injury.

机构信息

Sensorimotor Function Group, Hospital Nacional de Parapléjicos, Toledo, Spain IAI, Consejo Superior de Investigación Cientifíca (CSIC), Arganda del Rey, Spain.

Sensorimotor Function Group, Hospital Nacional de Parapléjicos, Toledo, Spain.

出版信息

NeuroRehabilitation. 2013;33(4):531-43. doi: 10.3233/NRE-131000.

Abstract

BACKGROUND

Although the spasticity syndrome is an important sensorimotor disorder, the impact of grade of lower limb muscle hypertonia, spasm and clonus activity on voluntary muscle function, gait and daily activities has not been systematically analysed during subacute and chronic spinal cord injury (SCI).

OBJECTIVE

To determine the prevalence of spasticity signs and symptoms during SCI, and to assess their impact on motor function and activities.

METHODS

A descriptive transverse study of sixty-six subjects with SCI was performed by assessing injury characteristics, spasticity (modified Ashworth scale, Penn scale, SCATS scale) and motor function (lower limb manual muscle scores, WISCI II, spinal cord injury spasticity evaluation tool).

RESULTS

Most subjects with the spasticity syndrome presented lower limb hypertonia and spasms during both subacute and chronic SCI, interfering with daily life activities. Subjects with incomplete SCI and hypertonia revealed a loss of voluntary flexor muscle activity, while extensors spasms contributed strongly to loss of gait function. The Penn spasms scale no correlated with muscle function or gait.

CONCLUSIONS

Specific diagnosis of spasm activity during subacute SCI, and its impact on lower limb voluntary muscle activity, gait function and daily activities, is required to develop a more effective neurorehabilitation treatment strategy.

摘要

背景

尽管痉挛综合征是一种重要的感觉运动障碍,但下肢肌肉张力、痉挛和阵挛活动的程度对亚急性和慢性脊髓损伤(SCI)后自主肌肉功能、步态和日常活动的影响尚未得到系统分析。

目的

确定 SCI 期间痉挛体征和症状的发生率,并评估其对运动功能和活动的影响。

方法

通过评估损伤特征、痉挛(改良 Ashworth 量表、Penn 量表、SCATS 量表)和运动功能(下肢手动肌肉评分、WISCI II、脊髓损伤痉挛评估工具),对 66 例 SCI 患者进行描述性横断面研究。

结果

大多数痉挛综合征患者在亚急性和慢性 SCI 期间均存在下肢高张力和痉挛,干扰日常生活活动。不完全性 SCI 和高张力患者表现出自主屈肌活动丧失,而伸肌痉挛强烈导致步态功能丧失。Penn 痉挛量表与肌肉功能或步态无相关性。

结论

需要对亚急性 SCI 期间的痉挛活动进行具体诊断,并评估其对下肢自主肌肉活动、步态功能和日常活动的影响,以制定更有效的神经康复治疗策略。

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