Physiotherapy Department, Epworth Hospital, Richmond 3121, Melbourne, Australia.
Physiotherapy Department, Epworth Hospital, Richmond 3121, Melbourne, Australia.
Clin Biomech (Bristol). 2023 Jul;107:105978. doi: 10.1016/j.clinbiomech.2023.105978. Epub 2023 May 3.
Spasticity is prevalent following Traumatic Brain Injury. 'Focal' muscle spasticity has been defined as spasticity affecting a localised muscle group, but it's impact on gait kinetics remains unclear. The aim of this study was to investigate the relationship between focal muscle spasticity and gait kinetics following Traumatic Brain Injury.
Ninety-three participants attending physiotherapy for mobility limitations following Traumatic Brain Injury were invited to participate in the study. Participants underwent clinical gait analysis and were grouped depending on the presence or absence of focal muscle spasticity. Kinetic data was obtained for each sub-group, and participants were compared to healthy controls.
Hip extensor power generation at initial contact, hip flexor power generation at terminal stance, and knee extensor power absorption at terminal stance were all significantly increased, and ankle power generation was significantly reduced at push-off when comparing Traumatic Brain Injury to healthy control populations. There were only two significant differences between participants with and without focal muscle spasticity, hip extensor power generation at initial contact was increased (1.53 vs 1.03 W/kg, P < .05) for those with focal hamstring spasticity, and knee extensor power absorption in early stance was reduced (-0.28 vs -0.64 W/kg, P < .05) for those with focal rectus femoris spasticity. However, these results should be interpreted with caution as the sub-group of participants with focal hamstring and rectus femoris spasticity was small.
Focal muscle spasticity had little association with abnormal gait kinetics in this cohort of independently ambulant people with Traumatic Brain Injury.
颅脑损伤后普遍存在痉挛。“局部”肌肉痉挛的定义为影响局部肌肉群的痉挛，但它对步态动力学的影响尚不清楚。本研究旨在探讨颅脑损伤后局部肌肉痉挛与步态动力学之间的关系。
邀请 93 名因移动障碍接受物理治疗的颅脑损伤患者参加研究。参与者接受临床步态分析，并根据是否存在局部肌肉痉挛进行分组。为每个子组获取动力学数据，并将参与者与健康对照组进行比较。
与健康对照组相比，颅脑损伤患者在初始接触时髋关节伸肌的功率产生、终末站立时髋关节屈肌的功率产生以及终末站立时膝关节伸肌的功率吸收均显著增加，而在推离时踝关节的功率产生显著降低。在有和没有局部肌肉痉挛的参与者之间，只有两个有显著差异，即有局部腘绳肌痉挛的参与者的初始接触时髋关节伸肌的功率产生增加（1.53 比 1.03 W/kg，P <.05），而有局部股直肌痉挛的参与者的早期站立时膝关节伸肌的功率吸收减少（-0.28 比-0.64 W/kg，P <.05）。然而，由于有局部腘绳肌和股直肌痉挛的参与者亚组较小，因此应谨慎解释这些结果。
在这组独立行走的颅脑损伤患者中，局部肌肉痉挛与异常步态动力学的相关性很小。
