Dean E, Ross J, MacIntyre D
School of Rehabilitation Medicine, University of British Columbia, Vancouver, Canada.
Phys Ther. 1989 Aug;69(8):695-8; discussion 698-9. doi: 10.1093/ptj/69.8.695.
This communication is in response to the article by Michael T Gross and Charles P Schuch entitled "Exercise Programs for Patients with Post-Polio Syndrome: A Case Report" published in the January 1989 issue of Physical Therapy. The investigators examined the effects of a rigorous isokinetic training program on peak torque of the knee flexor and extensor muscles of a post-polio patient. The literature on post-polio syndrome, however, does not support the use of either conventional muscle strengthening regimens or rigorous isokinetic exercise programs in the management of post-polio syndrome. In addition, based on the observation that there was no appreciable increase in muscle strength in either the affected or the apparently unaffected leg, the investigators concluded that their rigorous exercise program was not deleterious. The lack of a normal training response, however, is consistent with bilateral muscle fatigue secondary to overuse rather than muscle weakness secondary to disuse. This result is consistent with the need for a balance between rest and low-intensity exercise, which will help to maintain or enhance function while slowing rather than hastening further deterioration. We hope that this rejoinder clarifies some of the misconceptions that may arise from the Gross and Schuch article and that physical therapists consider very carefully the rationale for any type of exercise program for post-polio patients.
本通讯是对迈克尔·T·格罗斯（Michael T Gross）和查尔斯·P·舒赫（Charles P Schuch）发表于1989年1月《物理治疗》杂志上题为《小儿麻痹后遗症患者的运动项目：病例报告》一文的回应。研究者们研究了一项严格的等速训练项目对一名小儿麻痹后遗症患者膝部屈肌和伸肌峰值扭矩的影响。然而，关于小儿麻痹后遗症的文献并不支持在小儿麻痹后遗症的治疗中使用传统的肌肉强化方案或严格的等速运动项目。此外，基于观察到患侧或看似未受影响的腿部肌肉力量均未出现明显增加，研究者们得出结论，他们的严格运动项目并无危害。然而，缺乏正常的训练反应与过度使用导致的双侧肌肉疲劳相符，而非废用导致的肌肉无力。这一结果与在休息和低强度运动之间取得平衡的需求一致，这将有助于维持或增强功能，同时减缓而非加速进一步恶化。我们希望这一回应能澄清格罗斯和舒赫文章可能引发的一些误解，并且物理治疗师们能非常仔细地考虑针对小儿麻痹后遗症患者的任何类型运动项目的基本原理。
