Tay Matthew Rong Jie, Kong Keng He
Department of Rehabilitation Medicine, Tan Tock Seng Hospital, Singapore 308433, Singapore.
Centre of Rehabilitation Excellence, Tan Tock Seng Hospital, Singapore 308433, Singapore.
Life (Basel). 2022 Jul 18;12(7):1073. doi: 10.3390/life12071073.
Patients with incomplete spinal cord injury have decreased mobility, and many do not recover walking ability. The purpose of this study was to investigate rectus femoris muscle thickness and echo intensity on ultrasound and functional outcomes in these patients. This was a prospective cohort study in an inpatient rehabilitation center, which recruited 40 consecutive patients with incomplete spinal cord injury. The patients underwent an ultrasound assessment at 6 weeks post-injury. Ultrasound measurements were performed using B-mode ultrasound scanning and standardized protocols. Functional outcomes on discharge, including Lower Extremity Muscle Score (LEMS), Functional Independence Measure (FIM), and Walking Index for Spinal Cord Injury II (WISCI II), were measured. Rectus femoris muscle thickness was significantly correlated with discharge LEMS (Spearman’s rho = 0.448; p = 0.004), FIM motor subscale (Spearman’s rho = 0.595; p < 0.001), FIM walk subscale (Spearman’s rho = 0.621; p < 0.001) and WISCI II (Spearman’s rho = 0.531; p < 0.001). The rectus femoris echo intensity was also significantly correlated with discharge LEMS (Spearman’s rho = −0.345; p = 0.029), FIM motor subscale (Spearman’s rho = −0.413; p = 0.008), FIM walk subscale (Spearman’s rho = −0.352; p = 0.026), and WISCI II (Spearman’s rho = −0.355; p = 0.025). We report that a relationship exists between rectus femoris muscle ultrasonographic characteristics and muscle function and ambulatory outcomes after inpatient rehabilitation. Ultrasound muscle measurements are potentially useful in assessing muscle wasting and function in patients with spinal cord injury.
不完全性脊髓损伤患者的活动能力下降，许多患者无法恢复行走能力。本研究的目的是调查这些患者股直肌的肌肉厚度、超声回声强度及功能结局。这是一项在住院康复中心进行的前瞻性队列研究，连续招募了40例不完全性脊髓损伤患者。患者在受伤后6周接受了超声评估。超声测量采用B型超声扫描和标准化方案。测量了出院时的功能结局，包括下肢肌肉评分（LEMS）、功能独立性测量（FIM）和脊髓损伤步行指数II（WISCI II）。股直肌厚度与出院时的LEMS（斯皮尔曼等级相关系数ρ = 0.448；p = 0.004）、FIM运动亚量表（斯皮尔曼等级相关系数ρ = 0.595；p < 0.001）、FIM步行亚量表（斯皮尔曼等级相关系数ρ = 0.621；p < 0.001）和WISCI II（斯皮尔曼等级相关系数ρ = 0.531；p < 0.001）显著相关。股直肌回声强度也与出院时的LEMS（斯皮尔曼等级相关系数ρ = -0.345；p = 0.029）、FIM运动亚量表（斯皮尔曼等级相关系数ρ = -0.413；p = 0.008）、FIM步行亚量表（斯皮尔曼等级相关系数ρ = -0.352；p = 0.026）和WISCI II（斯皮尔曼等级相关系数ρ = -0.355；p = 0.025）显著相关。我们报告，股直肌肌肉超声特征与住院康复后的肌肉功能及步行结局之间存在关联。超声肌肉测量在评估脊髓损伤患者的肌肉萎缩和功能方面可能有用。
