Kristensen Otto H, Stenager Egon, Dalgas Ulrik
Department of Public Health, Section of Sport Science, Aarhus University, Aarhus, Denmark.
Neurological Research Unit and Department of Neurology, Soenderborg Hospital, Soenderborg, Denmark; Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark.
Arch Phys Med Rehabil. 2017 Feb;98(2):368-380. doi: 10.1016/j.apmr.2016.05.023. Epub 2016 Jun 29.
To systematically review (1) psychometric properties of criterion isokinetic dynamometry testing of muscle strength in persons with poststroke hemiplegia (PPSH); and (2) literature that compares muscle strength in patients poststroke with that in healthy controls assessed by criterion isokinetic dynamometry.
A systematic literature search of 7 databases was performed.
Included studies (1) enrolled participants with definite poststroke hemiplegia according to defined criteria; (2) assessed muscle strength or power by criterion isokinetic dynamometry; (3) had undergone peer review; and (4) were available in English or Danish.
The psychometric properties of isokinetic dynamometry were reviewed with respect to reliability, validity, and responsiveness. Furthermore, comparisons of strength between paretic, nonparetic, and comparable healthy muscles were reviewed.
Twenty studies covering 316 PPSH were included. High intraclass correlation coefficient (ICC) inter- and intrasession reliability was reported for isokinetic dynamometry, which was independent of the tested muscle group, contraction mode, and contraction velocity. Slightly higher ICC values were found for the nonparetic extremity. Standard error of the mean (SEM) values showed that a change of 7% to 20% was required for a real group change to take place for most muscle groups, with the knee extensors showing the smallest SEM% values. The muscle strength of paretic muscles showed deficits when compared with both healthy and nonparetic muscles, independent of muscle group, contraction mode, and contraction velocity. Nonparetic muscles only showed minor strength impairments when compared with healthy muscles.
Criterion isokinetic dynamometry is a reliable test in persons with stroke, generally showing marked reductions in muscle strength of paretic and, to a lesser degree, nonparetic muscles when compared with healthy controls, independent of muscle group, contraction mode, and contraction velocity.
系统评价(1) 中风后偏瘫患者（PPSH）肌肉力量的标准等速测力测试的心理测量学特性；(2) 通过标准等速测力法比较中风后患者与健康对照者肌肉力量的文献。
对7个数据库进行了系统的文献检索。
纳入的研究(1) 根据既定标准招募明确患有中风后偏瘫的参与者；(2) 通过标准等速测力法评估肌肉力量或功率；(3) 经过同行评审；(4) 有英文或丹麦文版本。
对等速测力法的心理测量学特性进行了可靠性、有效性和反应性方面的评价。此外，还对患侧、非患侧和可比健康肌肉之间的力量比较进行了评价。
纳入了20项研究，共316名PPSH患者。报告了等速测力法在组间和组内具有较高的组内相关系数（ICC）可靠性，且与测试的肌肉群、收缩模式和收缩速度无关。非患侧肢体的ICC值略高。平均标准误（SEM）值表明，大多数肌肉群要发生真正的组间变化，需要7%至20%的变化，其中膝伸肌的SEM%值最小。与健康肌肉和非患侧肌肉相比，患侧肌肉的力量均有缺陷，且与肌肉群、收缩模式和收缩速度无关。与健康肌肉相比，非患侧肌肉仅表现出轻微的力量损伤。
标准等速测力法对中风患者是一种可靠的测试方法，与健康对照者相比，通常显示患侧肌肉力量明显降低，非患侧肌肉力量降低程度较小，且与肌肉群、收缩模式和收缩速度无关。
