Master Program in Rehabilitation Sciences, Universidade De Brasília (UnB), Campus UnB Ceilândia, Brasília, Brazil; Spinal Cord Injury Department, Sarah Hospital Rehabilitation Network, Brasilia, Brazil.
Spinal Cord Injury Department, Sarah Hospital Rehabilitation Network, Brasilia, Brazil.
Gait Posture. 2020 May;78:65-71. doi: 10.1016/j.gaitpost.2020.03.014. Epub 2020 Apr 2.
Individuals with incomplete spinal cord injury (iSCI) might show muscle fatigability during walking, primarily over long distances. The cause can be related to the motor impairment and walking compensations identified in this population. However, evidence on the occurrence of muscle fatigability after prolonged walking in individuals with iSCI is conflicting.
Does prolonged walking cause higher muscle fatigability in individuals with iSCI compared with matched-controls?
We adopted a repeated measures design, in which maximal voluntary isometric contractions were performed before and after a walking test to induce the fatigability, in 24 individuals with iSCI and 24 matched-controls. Body weight-normalized peak torque (PT/BW), rate of force development (RFD), root mean square (RMS) and neuromuscular efficiency were used to assess the muscle fatigability. A mixed model ANOVA (2 × 2) was used for between-group and within-group comparisons. The significance was set in 5%.
Individuals with iSCI showed a greater decline in the PT/BW and RMS after the walking test. However, the RFD presented a greater decrease in the control group.
Our results showed that prolonged walking caused higher muscle fatigability in individuals with iSCI compared to healthy individuals. Therefore, muscle fatigability should be considered during the rehabilitation planning and in activities of daily living of individuals with iSCI. Moreover, the identification of muscle fatigability in individuals with iSCI might be useful to prevent high levels of physical exertion and, possibly, the risk of fall.
不完全性脊髓损伤（iSCI）患者在行走时可能会出现肌肉疲劳，主要是在长距离行走时。其原因可能与该人群中发现的运动损伤和行走代偿有关。然而，关于 iSCI 患者长时间行走后肌肉疲劳发生的证据存在争议。
与匹配对照组相比，长时间行走是否会导致 iSCI 患者的肌肉疲劳程度更高？
我们采用重复测量设计，在行走试验前后进行最大等长等速收缩，以诱导疲劳，共有 24 名 iSCI 患者和 24 名匹配对照组参与。采用归一化峰值扭矩（PT/BW）、力发展速率（RFD）、均方根（RMS）和神经肌肉效率来评估肌肉疲劳。采用 2×2 混合模型方差分析进行组间和组内比较。显著性水平设定为 5%。
iSCI 患者在行走试验后 PT/BW 和 RMS 下降更为明显。然而，对照组的 RFD 下降更为明显。
我们的结果表明，与健康个体相比，长时间行走会导致 iSCI 患者的肌肉疲劳程度更高。因此，在 iSCI 患者的康复计划和日常生活活动中应考虑肌肉疲劳。此外，iSCI 患者肌肉疲劳的识别可能有助于防止高强度体力活动，并可能降低跌倒风险。
