Williams Gavin, Banky Megan, Olver John
a Epworth Hospital , Melbourne , Australia.
b The University of Melbourne , Melbourne , Australia.
Brain Inj. 2015 Sep;29(10):1232-1238. doi: 10.3109/02699052.2015.1035328. Epub 2015 Jun 17.
To determine whether the severity of lower limb spasticity had a differential effect on mobility following traumatic brain injury (TBI) and to investigate whether the distribution of lower limb spasticity influenced compensation strategies when walking.
Ninety-three people attending physiotherapy for mobility limitations following TBI participated in this study. Participants were grouped according to the presence and distribution of lower limb spasticity for comparison.
Mobility was measured using a 10-metre walk test and the high level mobility assessment tool. Three dimensional gait analysis was used to measure power generation and spasticity was assessed using the Tardieu scale. No significant relationship was found between the severity of lower limb spasticity and mobility limitations. There was a strong relationship between ankle power generation and mobility performance. Proximal compensation strategies did not vary significantly between groups with different distributions of lower limb spasticity.
The ability to generate ankle power has a large impact on mobility outcome following TBI. Although spasticity was prevalent, the severity and distribution did not appear to impact mobility outcomes. Proximal compensation strategies were not influenced by the distribution of lower limb spasticity following TBI.
确定创伤性脑损伤（TBI）后下肢痉挛的严重程度对活动能力是否有不同影响，并调查下肢痉挛的分布在行走时是否会影响代偿策略。
93名因TBI导致活动受限而接受物理治疗的患者参与了本研究。根据下肢痉挛的存在情况和分布进行分组以作比较。
使用10米步行测试和高级活动能力评估工具测量活动能力。采用三维步态分析来测量力量产生，并使用Tardieu量表评估痉挛情况。未发现下肢痉挛严重程度与活动受限之间存在显著关系。踝关节力量产生与活动能力表现之间存在密切关系。不同下肢痉挛分布组之间的近端代偿策略没有显著差异。
产生踝关节力量的能力对TBI后的活动结果有很大影响。尽管痉挛普遍存在，但其严重程度和分布似乎并未影响活动结果。TBI后近端代偿策略不受下肢痉挛分布的影响。
