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脑卒中患者躯干肌肉等速分析及其与功能参数的关系。

Isokinetic Analysis of Trunk Muscles in Stroke Patients and its Association with Functional Parameters.

机构信息

KTO Karatay Universıty Medical Faculty, Medicana Hospital, Physical Medicine and Rehabilitation Department, Konya/Turkey.

Aksaray Universıty Medical Faculty, Department of Physical Medicine and Rehabilitation, Aksaray/Turkey.

出版信息

J Stroke Cerebrovasc Dis. 2020 Dec;29(12):105329. doi: 10.1016/j.jstrokecerebrovasdis.2020.105329. Epub 2020 Sep 30.

Abstract

OBJECTIVE

The purpose of our study is to investigate the association of balance, motor and functional development parameters with trunk muscles via isokinetic analysis in stroke patients due to cerebrovascular event.

METHODS

The study included 91 stroke patients and 28 healthy controls. Brunnstroom staging (BS) for motor functions, functional independence measurement (FIM) and Barthel index (BI) for disability, Berg balance scale (BBS) balance test for balance, Rivermead motor evaluation (RMA) for mobility, and mini-mental test (MMT) for cognitive function were used. Strength and proprioception measurements of patients and controls' trunk extensor and flexor muscles were evaluated via exercise system and isokinetic test.

RESULTS

A strong positive correlation was found between FIM total score and lower-extremity Brunnstrom staging (p < 0.001). A strong positive correlation was found between trunk control test (TCT), and FIM total scores (p < 0.001, r = 0.892), BI (p < 0.001, r = 0.799) and BBS (p = 0.01, r = 0.885). Isokinetic muscle strength values of controls were found statistically significantly higher than those in patients with stroke (p < 0.001). Trunk control and proprioception were poor in patients with stroke compared to the control group (p <0.001). Trunk muscles performance measures were significantly associated with balance and functional parameters. However, no significant relationship was found between the angular values of trunk muscle proprioception and clinical parameters in patients with stroke.

CONCLUSIONS

In stroke patients, trunk muscles were weak and trunk proprioception was impaired. So, inserting exercise programs to strengthen trunk muscles and improve trunk proprioception through isokinetic dynamometers or conventional methods into the rehabilitation programs of patients with muscle weakness and proprioception disorder may provide a better functional development.

摘要

目的

本研究旨在通过对脑血管意外后脑卒中患者的等速分析,探讨平衡、运动和功能发育参数与躯干肌肉的关系。

方法

本研究纳入了 91 例脑卒中患者和 28 例健康对照者。采用 Brunnstrom 运动功能分期(BS)、功能独立性测量(FIM)和巴氏指数(BI)评估运动功能和残疾程度,Berg 平衡量表(BBS)评估平衡,Rivermead 运动评估(RMA)评估活动能力,迷你精神状态检查(MMT)评估认知功能。通过运动系统和等速测试评估患者和对照组躯干伸肌和屈肌的力量和本体感觉测量值。

结果

FIM 总分与下肢 Brunnstrom 分期呈强正相关(p<0.001)。躯干控制测试(TCT)与 FIM 总分(p<0.001,r=0.892)、BI(p<0.001,r=0.799)和 BBS(p=0.01,r=0.885)呈强正相关。对照组的等速肌肉力量值明显高于脑卒中患者(p<0.001)。与对照组相比,脑卒中患者的躯干控制和本体感觉较差(p<0.001)。躯干肌肉功能测量值与平衡和功能参数显著相关。然而,在脑卒中患者中,躯干肌肉本体感觉的角度值与临床参数之间没有发现显著的关系。

结论

在脑卒中患者中,躯干肌肉较弱,躯干本体感觉受损。因此,在肌肉无力和本体感觉障碍患者的康复计划中,通过等速测力计或常规方法插入增强躯干肌肉和改善躯干本体感觉的锻炼计划,可能会提供更好的功能发育。

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