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中风后手屈伸过程中肌纤维传导速度的分析

Analysis of muscle fiber conduction velocity during finger flexion and extension after stroke.

作者信息

Conrad Megan O, Qiu Dan, Hoffmann Gilles, Zhou Ping, Kamper Derek G

机构信息

a Department of Industrial and Systems Engineering , School of Engineering and Applied Science, Oakland University , Rochester , MI , USA.

b Department of Biomedical Engineering , Illinois Institute of Technology , Chicago , IL , USA.

出版信息

Top Stroke Rehabil. 2017 May;24(4):262-268. doi: 10.1080/10749357.2016.1277482. Epub 2017 Jan 5.

Abstract

BACKGROUND

Stroke survivors experience greater strength deficits during finger extension than finger flexion. Prior research indicates relatively little observed weakness is directly attributable to muscle atrophy. Changes in other muscle properties, however, may contribute to strength deficits.

OBJECTIVES

This study measured muscle fiber conduction velocity (MFCV) in a finger flexor and extensor muscle to infer changes in muscle fiber-type after stroke.

METHODS

Conduction velocity was measured using a linear EMG surface electrode array for both extensor digitorum communis and flexor digitorum superficialis in 12 stroke survivors with chronic hand hemiparesis and five control subjects. Measurements were made in both hands for all subjects. Stroke survivors had either severe (n = 5) or moderate (n = 7) hand impairment.

RESULTS

Absolute MFCV was significantly lower in the paretic hand of severely impaired stroke patients compared to moderately impaired patients and healthy control subjects. The relative MFCV between the two hands, however, was quite similar for flexor muscles across all subjects and for extensor muscles for the neurologically intact control subjects. However, MFCV for finger extensors was smaller in the paretic as compared to the nonparetic hand for both groups of stroke survivors.

CONCLUSIONS

One explanation for reduced MFCV may be a type-II to type-I muscle fiber, especially in extrinsic extensors. Clinically, therapists may use this information to develop therapeutic exercises targeting loss of type-II fiber in extensor muscles.

摘要

背景

中风幸存者在手指伸展时比手指屈曲时经历更大的力量缺陷。先前的研究表明,观察到的相对较少的虚弱直接归因于肌肉萎缩。然而,其他肌肉特性的变化可能导致力量缺陷。

目的

本研究测量了手指屈肌和伸肌的肌纤维传导速度(MFCV),以推断中风后肌纤维类型的变化。

方法

使用线性肌电图表面电极阵列测量12名患有慢性手部偏瘫的中风幸存者和5名对照受试者的指总伸肌和指浅屈肌的传导速度。对所有受试者的双手进行测量。中风幸存者有严重(n = 5)或中度(n = 7)手部损伤。

结果

与中度受损患者和健康对照受试者相比,严重受损中风患者患侧手的绝对MFCV显著更低。然而,所有受试者屈肌的双手相对MFCV以及神经功能正常的对照受试者伸肌的双手相对MFCV相当相似。然而,两组中风幸存者患侧手指伸肌的MFCV均小于非患侧手。

结论

MFCV降低的一种解释可能是II型到I型肌纤维的转变,尤其是在手部外在伸肌中。临床上,治疗师可以利用这些信息制定针对伸肌中II型纤维损失的治疗性锻炼。

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