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不同负荷的即刻作用不会改变运动障碍型脑瘫青年上肢肌肉的共同激活。

The immediate effect of different loads does not alter muscle co-activation of the upper limb in young adults with dyskinetic cerebral palsy.

机构信息

Department of Rehabilitation Science, Human Motion Analysis Laboratory, Universidade Nove de Julho, São Paulo, Brazil.

Department of Rehabilitation Science, Human Motion Analysis Laboratory, Universidade Nove de Julho, São Paulo, Brazil.

出版信息

Gait Posture. 2021 Oct;90:161-166. doi: 10.1016/j.gaitpost.2021.08.018. Epub 2021 Aug 27.

Abstract

BACKGROUND

There is insufficient information on muscle co-activation in the upper limbs to help healthcare providers develop treatment programs for patients with dyskinetic cerebral palsy (DCP).

RESEARCH QUESTION

Is the degree of muscle co-activation greater in adults with DCP than in healthy individuals? Does the use of different arm weights modify co-contraction in individuals with PCD?

METHODS

Fourteen healthy individuals (control group [CG]) and 14 individuals with DCP (dyskinetic group [DG]) participated in the study. The degree of muscle co-activation of the dominant limb during drinking from a mug was compared between the two groups. The task was divided into a going, adjusting, and returning phase. In the DG, an analysis was also performed on using an arm weight during the functional task. The loads corresponded to 10, 20, and 30 % of maximum isometric muscle strength measured in each participant.

RESULTS

In comparing the two groups, the DG exhibited a greater muscle co-activation in the shoulder and elbow muscles during the going phase, the shoulder, elbow, and wrist during the adjusting phase; and the elbow during the returning phase. The DG also showed a greater mean index of curvature (MIC), time to perform the movement phases, and lesser mean velocity (Vm) to drinking. In analyzing the DG's arm weight, no effect on co-activation, MIC, time to perform the movement phases, and Vm to drinking were found with the loads tested (p > 0.05).

CONCLUSION

Muscle co-activation is increased in adults with DCP in comparison to healthy individuals. Moreover, arm weight during the functional activity of drinking from a mug did not alter co-activation, although an immediate effect was expected.

摘要

背景

在上肢肌肉协同收缩方面,针对脑瘫运动障碍患者的治疗方案,相关医学信息还不够充分。

研究问题

脑瘫运动障碍患者的上肢肌肉协同收缩程度是否高于健康人群?使用不同的手臂重量是否会改变脑瘫患者的协同收缩?

方法

本研究纳入了 14 名健康个体(对照组 [CG])和 14 名脑瘫运动障碍患者(脑瘫组 [DG])。比较了两组患者在使用杯子喝水时的优势侧上肢肌肉协同收缩程度。该任务分为去程、调整和回程三个阶段。在 DG 中,还分析了在功能性任务中使用手臂重量的情况。所使用的负荷分别对应于每个参与者最大等长肌肉力量的 10%、20%和 30%。

结果

在比较两组患者时,发现 DG 在去程时,肩部和肘部肌肉的协同收缩程度更高,在调整阶段,肩部、肘部和腕部的协同收缩程度更高;在回程阶段,肘部的协同收缩程度更高。此外,DG 的平均曲率指数(MIC)、完成运动阶段的时间和平均速度(Vm)到饮水也更大。在分析 DG 的手臂重量时,未发现所测试的负荷对协同收缩、MIC、完成运动阶段的时间和 Vm 到饮水有影响(p>0.05)。

结论

与健康人群相比,脑瘫运动障碍患者的上肢肌肉协同收缩增加。此外,尽管预期会产生即时影响,但在功能性饮水活动中使用手臂重量不会改变协同收缩。

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