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慢性脑卒中患者中股四头肌特性和姿势稳定性的横断面研究:受限与非受限社区步行能力。

Cross-sectional study of quadriceps properties and postural stability in patients with chronic stroke and limited vs. non-limited community ambulation.

机构信息

Physiotherapy in Motion. Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia , Valencia , Spain.

Intelligent Data Analysis Laboratory, University of Valencia , Valencia , Spain.

出版信息

Top Stroke Rehabil. 2019 Oct;26(7):503-510. doi: 10.1080/10749357.2019.1634360. Epub 2019 Jun 27.

Abstract

: Changes in the paretic-side metabolism post-stroke and quadriceps muscle mechanical properties favour muscle wasting, affecting postural instability and walking impairment. Further clarification is needed in subjects post-stroke who show limited or non-limited community ambulation. : To analyze between-limb differences in quadriceps muscle thickness, strength and thigh cutaneous temperature, as well as investigate postural stability in subjects with chronic stroke and limited vs. non-limited community ambulation and compared against healthy controls. : In this controlled cross-sectional study, 26 participants with chronic hemiparesis post-stroke (divided in a slow gait group (SG<0.8 m/s) (n = 13) and a fast gait group with full community ambulation speed (FG≥0.8 m/s)) and 18 healthy people were recruited. Thigh surface temperature, rectus femoris (RF) and vastus intermedius (VI) muscles thickness, quadriceps' isometric maximal voluntary contraction and postural stability were measured. : The SG presented significantly lower RF ( = .019) and VI ( = .006) muscle thickness, less peak force ( < .001) and lower temperature ( = .002) in the paretic vs the non-paretic limb. The FG showed significantly lower VI thickness ( = .036) and peak force ( < .001) in the paretic vs the non-paretic limb. Regarding balance, all indices were worse in the SG versus the FG and CG. : Subjects of the FG, despite showing full community ambulation speed, had less quadriceps strength and VI muscle thickness but not RF muscle wasting in the paretic limb. The paretic VI muscle wasting may be an important factor to reach normal walking. The SG showed between-limb differences in all the studied variables and the worst postural stability.

摘要

: 中风后患侧代谢的变化和股四头肌的机械特性有利于肌肉萎缩,影响姿势的稳定性和步行能力。对于社区步行能力有限或无限制的中风后患者,需要进一步澄清。 : 分析慢性中风患者双侧股四头肌厚度、力量和大腿皮肤温度的差异,并研究社区步行能力有限与无限制的慢性中风患者与健康对照组之间的姿势稳定性。 : 在这项对照性横断面研究中,招募了 26 名慢性偏瘫中风后患者(分为慢步组(SG<0.8 m/s)(n=13)和快步组,具有全社区步行速度(FG≥0.8 m/s))和 18 名健康人。测量了大腿表面温度、股直肌(RF)和股中间肌(VI)厚度、股四头肌等长最大自主收缩和姿势稳定性。 : SG 组患侧的 RF( = 0.019)和 VI( = 0.006)肌肉厚度显著较低,峰值力( < 0.001)和温度( = 0.002)也较低。FG 组患侧的 VI 厚度( = 0.036)和峰值力( < 0.001)显著较低。关于平衡,所有指标在 SG 组均显著差于 FG 组和 CG 组。 : 尽管 FG 组显示出全社区步行速度,但在患侧股四头肌力量和 VI 肌肉厚度方面较差,但 RF 肌肉萎缩不明显。患侧 VI 肌肉萎缩可能是达到正常行走的一个重要因素。SG 组在所有研究变量和最差的姿势稳定性方面都存在双侧差异。

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