Ramsay John W, Buchanan Thomas S, Higginson Jill S
Biomechanics and Movement Science Program, University of Delaware, Newark, DE 19716, USA ; Delaware Rehabilitation Institute, University of Delaware, Newark, DE 19713, USA.
Stroke Res Treat. 2014;2014:919486. doi: 10.1155/2014/919486. Epub 2014 Jul 23.
Poststroke plantar flexor muscle weakness has been attributed to muscle atrophy and impaired activation, which cannot collectively explain the limitations in force-generating capability of the entire muscle group. It is of interest whether changes in poststroke plantar flexor muscle fascicle length and pennation angle influence the individual force-generating capability and whether plantar flexor weakness is due to uniform changes in individual muscle force contributions. Fascicle lengths and pennation angles for the soleus, medial, and lateral gastrocnemius were measured using ultrasound and compared between ten hemiparetic poststroke subjects and ten healthy controls. Physiological cross-sectional areas and force contributions to poststroke plantar flexor torque were estimated for each muscle. No statistical differences were observed for any muscle fascicle lengths or for the lateral gastrocnemius and soleus pennation angles between paretic, nonparetic, and healthy limbs. There was a significant decrease (P < 0.05) in the paretic medial gastrocnemius pennation angle compared to both nonparetic and healthy limbs. Physiological cross-sectional areas and force contributions were smaller on the paretic side. Additionally, bilateral muscle contributions to plantar flexor torque remained the same. While the architecture of each individual plantar flexor muscle is affected differently after stroke, the relative contribution of each muscle remains the same.
中风后跖屈肌肌无力被认为与肌肉萎缩和激活受损有关,但这并不能完全解释整个肌肉群力量产生能力的局限性。中风后跖屈肌肌束长度和羽状角的变化是否会影响个体力量产生能力,以及跖屈肌无力是否是由于个体肌肉力量贡献的均匀变化所致,这是一个值得关注的问题。使用超声测量了比目鱼肌、内侧腓肠肌和外侧腓肠肌的肌束长度和羽状角,并在10名中风后偏瘫患者和10名健康对照者之间进行了比较。估计了每块肌肉的生理横截面积和对中风后跖屈扭矩的力量贡献。在患侧、非患侧和健康肢体之间,未观察到任何肌肉肌束长度、外侧腓肠肌和比目鱼肌羽状角的统计学差异。与非患侧和健康肢体相比,患侧内侧腓肠肌羽状角显著减小(P < 0.05)。患侧的生理横截面积和力量贡献较小。此外,双侧肌肉对跖屈扭矩的贡献保持不变。虽然中风后每块单独的跖屈肌结构受到的影响不同,但每块肌肉的相对贡献保持不变。