Marusiak Jarosław, Jaskólska Anna, Budrewicz Sławomir, Koszewicz Magdalena, Andrzejewska Renata, Kisiel-Sajewicz Katarzyna, Jaskólski Artur
Department of Kinesiology, Faculty of Physiotherapy, University School of Physical Education, Wrocław, Poland.
Department of Neurology, Medical University of Wrocław, Wrocław, Poland.
Acta Bioeng Biomech. 2018;20(4):75-82.
Heightened tonic stretch reflex contributes to increased muscle tone and a more-flexed resting elbow joint angle (EJA) in patients with Parkinson's disease (PD). Dopaminergic medication restores central nervous system (CNS) functioning and decreases resting muscle electrical and mechanical activities. This study aimed to evaluate the effects of dopaminergic medication on parkinsonian rigidity, resting EJA, resting electrical activity (electromyography, EMG) and mechanical properties (myotonometry, MYO) of elbow flexor muscles and the associations of EJA with these muscles resting electrical activity and mechanical properties in PD patients. We also evaluated a relationship between dopaminergic treatment dose and these outcome measures values.
Ten PD patients (age 68 ± 10.1 years; body mass 70 ± 16.8 kg; height 162 ± 6.6 cm; illness duration 9 ± 4.5 years) were tested during medication on- and off-phases. Resting EJA, myotonometric muscle stiffness (S-MYO) and root mean square electromyogram amplitude (RMS-EMG) were recorded from relaxed biceps brachii and brachioradialis muscles. Based on the above parameters, we also calculated the EJA/S-MYO ratio and EJA/RMS-EMG ratio. Parkinsonian rigidity was assessed using the motor section of the Unified Parkinson's Disease Rating Scale.
EJA, EJA/S-MYO ratio, and EJA/RMS-EMG ratio were increased and S-MYO, RMS-EMG, and parkinsonian rigidity were decreased during the medication on-phase compared with the off-phase. In addition, the dopaminergic treatment dose was negatively correlated with S-MYO and RMS-EMG, and positively correlated with EJA/SMYO and EJA/RMS-EMG ratios.
We conclude that dopaminergic medication- induced improvements in resting elbow joint angle in tested patients with PD are related to changes in their muscle electrical and mechanical properties.
强直性牵张反射增强导致帕金森病（PD）患者肌肉张力增加以及静息时肘关节角度（EJA）更屈曲。多巴胺能药物可恢复中枢神经系统（CNS）功能，并降低静息肌肉的电活动和机械活动。本研究旨在评估多巴胺能药物对PD患者帕金森病性强直、静息EJA、肘关节屈肌静息电活动（肌电图，EMG）和机械特性（肌动测量法，MYO）的影响，以及EJA与这些肌肉静息电活动和机械特性之间的关联。我们还评估了多巴胺能治疗剂量与这些结果测量值之间的关系。
对10例PD患者（年龄68±10.1岁；体重70±16.8kg；身高162±6.6cm；病程9±4.5年）在服药期和停药期进行测试。记录肱二头肌和肱桡肌放松时的静息EJA、肌动测量法测得的肌肉僵硬度（S-MYO）和肌电图均方根振幅（RMS-EMG）。基于上述参数，我们还计算了EJA/S-MYO比值和EJA/RMS-EMG比值。使用统一帕金森病评定量表的运动部分评估帕金森病性强直。
与停药期相比，服药期EJA、EJA/S-MYO比值和EJA/RMS-EMG比值升高，S-MYO、RMS-EMG和帕金森病性强直降低。此外，多巴胺能治疗剂量与S-MYO和RMS-EMG呈负相关，与EJA/S-MYO和EJA/RMS-EMG比值呈正相关。
我们得出结论，多巴胺能药物使受试PD患者静息肘关节角度得到改善，这与他们肌肉的电特性和机械特性的变化有关。
