脑卒中后踝关节背屈肌力量、肌力发展速率和胫骨前肌肌电图的可靠性。
Reliability of ankle dorsiflexor muscle strength, rate of force development, and tibialis anterior electromyography after stroke.
机构信息
Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand.
Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
出版信息
F1000Res. 2024 Jun 4;12:423. doi: 10.12688/f1000research.132415.2. eCollection 2023.
BACKGROUND
Measures of hemiparetic ankle dorsiflexor muscle strength and rate of force development (RFD) are often used to determine the efficacy of rehabilitation interventions after stroke. However, evidence supporting the reliability of these measures is limited. This brief report provides a secondary analysis investigating the between-session reliability of isometric ankle dorsiflexor muscle strength, rate of force development (RFD), and tibialis anterior electromyography (TA EMG), in people with chronic stroke.
METHOD
Participants (n=15) completed three maximal isometric contractions of the ankle dorsiflexor muscles as fast as possible using a rigid dynamometer. Tests were repeated seven days later. Outcomes included ankle dorsiflexor isometric maximal voluntary contraction (MVC), RFD in the first 200ms (RFD200ms), time to reach 90% MVC, and peak TA EMG. Data were analysed for 13 participants using intra-class correlation coefficients (ICC) and standard error of the measure percentage (SEM%).
RESULTS
Reliability was higher when analysing the mean of three trials rather than the best of three trials. There was excellent reliability for isometric dorsiflexor MVC (ICC 0.97 [95% CI 0.92, 0.99], SEM% 7%). However, for other outcomes, while the ICC indicated good reliability, the lower bound of the 95% confidence interval of the ICC fell in the moderate range for TA EMG (ICC 0.86 [95% CI 0.60, 0.96], SEM% 25%) and time to reach 90% MVC (ICC 0.8 [95% CI 0.53, 0.93], SEM% 23%) and in the poor range for dorsiflexor RFD200ms (ICC 0.79 [95% CI 0.48, 0.92], SEM% 24%).
CONCLUSION
The findings raise concerns about the reliability of measures of rapid force production in the dorsiflexor muscles after stroke. Given the functional significance of the ankle dorsiflexors, larger studies should be conducted to further investigate these concerns and explore reliable methods for measuring rapid force production in the hemiparetic dorsiflexor muscles.
背景
在脑卒中后，评估偏瘫患者的踝背屈肌力量和力量发展速率（RFD）的措施常被用于评估康复干预的效果。然而，这些测量方法的可靠性证据有限。本简要报告提供了一项二次分析结果，该研究旨在评估慢性脑卒中患者的踝背屈肌等速最大力量、RFD（RFD200ms）以及胫骨前肌肌电图（TA EMG）的测试-再测试信度。
方法
参与者（n=15）使用刚性测力计以最快速度完成 3 次最大等长踝背屈肌收缩。7 天后重复测试。测量结果包括踝背屈肌等速最大自主收缩（MVC）、200ms 内的 RFD（RFD200ms）、达到 90% MVC 的时间以及 TA EMG 峰值。13 名参与者的数据采用组内相关系数（ICC）和测量值标准差百分比（SEM%）进行分析。
结果
与最佳 3 次测试相比，分析 3 次测试的平均值时，可靠性更高。等速踝背屈肌 MVC 的 ICC 为 0.97（95%置信区间为 0.92，0.99），SEM%为 7%，具有极好的可靠性。然而，对于其他结果，尽管 ICC 表明具有良好的可靠性，但 ICC 的 95%置信区间下限落入 TA EMG 的中等范围（ICC 为 0.86，95%置信区间为 0.60，0.96），SEM%为 25%，以及到达 90% MVC 的时间（ICC 为 0.8，95%置信区间为 0.53，0.93），SEM%为 23%，RFD200ms 的可靠性则较差（ICC 为 0.79，95%置信区间为 0.48，0.92），SEM%为 24%。
结论
这些发现使人们对脑卒中后背屈肌快速力量产生的测量方法的可靠性产生了担忧。鉴于踝背屈肌的功能重要性，应开展更大规模的研究，以进一步调查这些担忧，并探索测量偏瘫背屈肌快速力量的可靠方法。
Zotero 插件