Ditunno J F, Sipski M L, Posuniak E A, Chen Y T, Staas W E, Herbison G J
Arch Phys Med Rehabil. 1987 May;68(5 Pt 1):287-90.
Wrist extensor recovery is of major functional significance in many quadriplegic patients. In this retrospective study, we investigated a method for prognosticating wrist extensor recovery and the underlying mechanisms for improvement in strength. Thirty-five quadriplegic patients at the C4, C5, and C6 neurologic levels, admitted over a four-year period, were examined at one week, two months, and eight months postinjury for biceps and wrist extensor strength. Initial biceps strength was compared to final wrist extensor strength. All 16 C5 patients whose initial biceps strength was grade 3 showed wrist extensor improvement to grade 3; only three of 16 C4 patients showed the same improvement. We concluded that initial biceps strength is a reliable indicator of wrist extensor recovery, and most, if not all, C5 neurologic patients will gain one full motor level. This improvement may be due to compensatory factors, such as overwork hypertrophy and peripheral sprouting of nerves within the muscle, rather than to recovery of a root level.
对于许多四肢瘫痪患者来说，腕伸肌功能的恢复具有重要的功能意义。在这项回顾性研究中，我们研究了一种预测腕伸肌恢复的方法以及力量改善的潜在机制。在四年期间收治的35例C4、C5和C6神经水平的四肢瘫痪患者，在受伤后1周、2个月和8个月接受了肱二头肌和腕伸肌力量检查。将初始肱二头肌力量与最终腕伸肌力量进行比较。所有16例初始肱二头肌力量为3级的C5患者，其腕伸肌力量均改善至3级；16例C4患者中只有3例有同样的改善。我们得出结论，初始肱二头肌力量是腕伸肌恢复的可靠指标，并且大多数（如果不是全部）C5神经水平的患者将获得一个完整的运动水平提升。这种改善可能是由于诸如过劳性肥大和肌肉内神经的周围性芽生等代偿因素，而非神经根水平的恢复。
