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上运动神经元损伤踝关节处理中延长肌肉拉伸的证据:康复考量——一项系统评价

The evidence for prolonged muscle stretching in ankle joint management in upper motor neuron lesions: considerations for rehabilitation - a systematic review.

作者信息

Bani-Ahmed Ali

机构信息

a Department of Physical Therapy , University of Tabuk (UT) , Tabuk , Kingdom of Saudi Arabia (KSA).

出版信息

Top Stroke Rehabil. 2019 Mar;26(2):153-161. doi: 10.1080/10749357.2018.1550958. Epub 2018 Nov 26.

Abstract

BACKGROUND

As clinicians, muscles stretching approaches are one of the most commonly used interventions in rehabilitation. However, there is a need for an in-depth evaluation of research on prolonged stretching in terms of the features of the stretching approaches, such as duration and frequency, as well as the compatible measures of a successful stretching approach.

OBJECTIVE

This review is an effort to synthesize findings from studies on "prolonged" stretching approaches in patients with UMNs including stroke, spinal cord injuries, and traumatic brain injuries. We investigated the compatible features of successful stretching regimens in terms of reducing spasticity, improving the Active Range of Motion (AROM), Passive Range of Motion (PROM), and gait training of spastic patient with upper motor neuron lesions.

METHODS

Studies evaluating the effectiveness of "prolonged" stretching on spastic ankle planterflexor muscles and its complications were critically reviewed, and the level of evidence was analyzed.

RESULTS

There is a sufficient level of evidence to support the use of stretching as and effective techniques in rehabilitation. However, more research is yet to be done to objectively examine the ideal parameters of a successful stretching approach using functional assessments, such as walking, speed, walking capacity, and balance.

CONCLUSION

The review adds stronger understanding with regard to stretching considerations in rehabilitation following UMNs. The ideal approach, as well as the functional implications on motor performance are yet to be further studied.

摘要

背景

作为临床医生,肌肉拉伸方法是康复治疗中最常用的干预措施之一。然而,需要从拉伸方法的特征(如持续时间和频率)以及成功拉伸方法的配套措施等方面,对长时间拉伸的研究进行深入评估。

目的

本综述旨在综合有关包括中风、脊髓损伤和创伤性脑损伤在内的上运动神经元损伤患者“长时间”拉伸方法的研究结果。我们从降低痉挛程度、改善主动活动范围(AROM)、被动活动范围(PROM)以及对上运动神经元损伤痉挛患者进行步态训练等方面,研究了成功拉伸方案的适配特征。

方法

对评估“长时间”拉伸对痉挛性踝跖屈肌有效性及其并发症的研究进行了严格审查,并分析了证据水平。

结果

有足够的证据支持将拉伸作为康复治疗中的一种有效技术。然而,仍需开展更多研究,以通过功能评估(如行走、速度、行走能力和平衡)客观地检验成功拉伸方法的理想参数。

结论

本综述增强了对上运动神经元损伤后康复中拉伸考量的理解。理想的方法以及对运动表现的功能影响仍有待进一步研究。

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