The University of Melbourne, Melbourne, Australia (G.W.); and Epworth Healthcare, Richmond, Australia (G.W., M.B.).
J Neurol Phys Ther. 2022 Jul 1;46(3):213-218. doi: 10.1097/NPT.0000000000000400. Epub 2022 Apr 11.
Focal muscle spasticity is defined as spasticity that affects a localized group of muscles. It is prevalent in many adult-onset neurological conditions, yet the relationship of focal muscle spasticity with walking remains unclear. Therefore, the aim of this study was to determine the relationship of focal muscle spasticity with the kinematics of walking in traumatic brain injury (TBI).
Ninety-one participants with TBI underwent clinical gait analysis and assessment of focal lower limb muscle spasticity in a prospective cross-sectional study. A matched group of 25 healthy controls (HCs) were recruited to establish a reference dataset. Kinematic data for each person with and without focal muscle spasticity following TBI were compared with the HC cohort at a matched walking speed.
The TBI and HC cohorts were well matched. Only those with focal hamstring muscle spasticity walked significantly different to those without. They had significantly greater knee flexion (23.4° compared with 10.5°, P < 0.01) at initial contact. There were no other significant differences in kinematic variables between those with and without focal muscle spasticity. There was no significant association between focal muscle spasticity and walking speed.
Focal muscle spasticity and abnormal kinematics whilst walking were common in this cohort of people with TBI. However, focal muscle spasticity had little relationship with kinematic variables, and no significant relationship with walking speed. This finding has implications for the treatment of focal muscle spasticity to improve walking following TBI. Focal muscle spasticity had little relationship with kinematic variables and walking speed in this cohort of people with TBI who could walk without assistance.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A381).
局部肌肉痉挛性是指影响局部肌肉群的痉挛。它在许多成人发病的神经系统疾病中很常见，但局部肌肉痉挛性与行走之间的关系尚不清楚。因此，本研究的目的是确定创伤性脑损伤（TBI）中局部肌肉痉挛性与行走运动学之间的关系。
91 名 TBI 患者进行了临床步态分析和局部下肢肌肉痉挛性评估，这是一项前瞻性的横断面研究。招募了 25 名健康对照者（HCs）组成匹配组，以建立参考数据集。在匹配的行走速度下，比较了 TBI 后有和无局部肌肉痉挛性的个体与 HCs 队列的运动学数据。
TBI 和 HCs 队列匹配良好。只有那些有局部腘绳肌痉挛性的人行走时与那些没有的人明显不同。他们在初始接触时的膝关节屈曲明显更大（23.4°比 10.5°，P < 0.01）。在有和无局部肌肉痉挛性的个体之间，运动学变量没有其他显著差异。局部肌肉痉挛性与行走速度之间没有显著关联。
在本队列中，TBI 患者常见局部肌肉痉挛性和行走时的异常运动学。然而，局部肌肉痉挛性与运动学变量关系不大，与行走速度也没有显著关系。这一发现对治疗 TBI 后改善行走的局部肌肉痉挛性有影响。在本队列中，能够独立行走的 TBI 患者中，局部肌肉痉挛性与运动学变量和行走速度关系不大。
