Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China; Department of Neurology, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China.
Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China.
Neurosci Lett. 2019 Nov 1;712:134479. doi: 10.1016/j.neulet.2019.134479. Epub 2019 Sep 3.
Spasticity commonly occurs in hemiplegic patients with stroke, and clinical experience indicates that upper limb spasticity is more apparent when patients are standing than when they are lying down. Few reports have investigated how positional changes impact the spasticity of the upper limb and trigger a combined movement called the "hemiplegic posture".
The objective of this study was to explore the influence of different body positions on the spasticity of the upper extremity.
Eighty-four poststroke patients with upper limb spasticity were recruited for this study. We measured the spasticity of hemiplegic upper limbs involving elbow flexors, wrist flexors and digitorum flexors using the Modified Ashworth Scale (MAS), Modified Tardieu Scale (MTS) and Triple Spasticity Scale (TSS) in three positions, i.e., supine, sitting and standing. The results were obtained by comparing one position with another for each muscle.
All the MAS, MTS and TSS scores of all the muscles of the upper limb were significantly lower in the supine position than in the other positions (all P < 0.05), and the MTS and TSS scores were statistically higher while standing than while sitting (P < 0.05).
High modulation of spasticity in the upper limbs measured using the MAS, MTS and TSS when transitioning to the standing position from either the supine or sitting position demonstrated that posture plays a role in modulating the spasticity of the hemiplegic upper limb in poststroke patients.
痉挛在脑卒中偏瘫患者中较为常见，临床经验表明，患者站立时上肢痉挛较仰卧时明显。很少有研究探讨体位变化如何影响上肢痉挛，并引发一种称为“偏瘫姿势”的联合运动。
本研究旨在探讨不同体位对偏瘫上肢痉挛的影响。
本研究纳入 84 例上肢痉挛的脑卒中患者。采用改良 Ashworth 量表（MAS）、改良 Tardieu 量表（MTS）和三重痉挛量表（TSS）分别在仰卧位、坐位和站立位测量偏瘫上肢屈肘肌、腕屈肌和指屈肌的痉挛程度。通过比较每个肌肉在不同体位的结果，得出了三个体位之间的差异。
所有上肢肌肉的 MAS、MTS 和 TSS 评分在仰卧位时均明显低于其他体位（均 P<0.05），而 MTS 和 TSS 评分在站立位时明显高于坐位（P<0.05）。
从仰卧位或坐位转换到站立位时，MAS、MTS 和 TSS 测量的上肢痉挛高度调节表明，姿势在调节脑卒中后偏瘫上肢痉挛中起着作用。
