Akalan N Ekin, Kuchimov Shavkat, Apti Adnan, Temelli Yener, Ören Merve, Nene Anand
Physiotherapy and Rehabilitation Division, Faculty of Health Sciences, Istanbul Kultur University, Turkey.
Institute of Biomedical Engineering, Bogazici University, Istanbul, Turkey.
J Back Musculoskelet Rehabil. 2018;31(6):1201-1209. doi: 10.3233/BMR-171082.
Muscle strength is usually measured using isometric hand-held dynamometers (HHDs) in the clinic. However, during functional activities, the muscle acts more dynamically. The aim of this study was to investigate the relation between clinically measured plantar flexor (PF) muscle strength (PFMS) and laboratory measurements of peak ankle plantar flexion power generation (APFPG), peak ankle moment (PAM), peak plantar flexion velocity (PFV) and mean gait velocity in healthy participants.
The maximum PFMS on non-dominant sides in 18 able-bodied persons 23.88 (SD 3.55 years) was measured before (Pre-S) and after a stretching (Post-S) procedure (135 sec. × 13 rep. with 5 sec. rest) by using a HHD. The stretching procedure was used to generate temporary PF muscle weakness. Gait analysis was carried out for Pre-S and Post-S conditions. Normalized (by weight and height) and non-normalized HHD scores and differences for both conditions were correlated by Pearson correlation coefficient calculations (p< 0.05).
Reduced PFMS (%23, p< 0.001) in Post-S, according to the HHD scores, has only a weak correlation with APFPG (r> 0.3, p< 0.5). Gait velocity was found to be strongly correlated with APFPG only in the Post-S condition (r= 0.68, p< 0.002). HHD scores and PAM were moderately correlated with the non-normalized Post-S condition (r= 0.44, p= 0.70) and strongly correlated with the non-normalized Pre-S condition (r= 0.62, p< 0.01).
HHD scores of plantar flexor muscles give very limited information about the PF performance during walking in healthy individuals. Simple normalization did not improve the relations. Clinically measured isometric muscle strength and muscle weakness have only moderate strengths for establishing a treatment protocol and for predicting performance during walking in neurologically intact individuals.
在临床中，肌肉力量通常使用等长手持式测力计（HHD）进行测量。然而，在功能活动期间，肌肉的作用更具动态性。本研究的目的是调查健康参与者临床测量的跖屈（PF）肌力量（PFMS）与实验室测量的踝关节跖屈峰值功率生成（APFPG）、踝关节峰值力矩（PAM）、跖屈峰值速度（PFV）以及平均步态速度之间的关系。
使用HHD在拉伸程序（135秒×13次重复，每次休息5秒）之前（预拉伸，Pre-S）和之后（后拉伸，Post-S）测量18名23.88岁（标准差3.55岁）身体健全者非优势侧的最大PFMS。拉伸程序用于产生暂时性PF肌无力。对预拉伸和后拉伸条件进行步态分析。通过Pearson相关系数计算（p<0.05），对两种条件下归一化（按体重和身高）和未归一化的HHD分数及差异进行相关性分析。
根据HHD分数，后拉伸时PFMS降低（23%，p<0.001），与APFPG仅具有弱相关性（r>0.3，p<0.5）。仅在后拉伸条件下发现步态速度与APFPG高度相关（r = 0.68，p<0.002）。HHD分数与PAM在后拉伸未归一化条件下呈中度相关（r = 0.44，p = 0.70），在预拉伸未归一化条件下呈高度相关（r = 0.62，p<0.01）。
跖屈肌的HHD分数对于健康个体行走期间的PF表现提供的信息非常有限。简单归一化并未改善这种关系。临床测量的等长肌力和肌无力对于制定治疗方案以及预测神经功能正常个体行走期间的表现仅具有中等强度。
