Sloan K E, Bremner L A, Byrne J, Day R E, Scull E R
Department of Medical Physics, Royal Perth Hospital, Australia.
Paraplegia. 1994 Jun;32(6):407-15. doi: 10.1038/sc.1994.67.
Twelve patients were involved in a 3 month stimulation induced cycling programme at the Royal Perth Rehabilitation Hospital. A number of the patients were less than 1 year post injury, all except one had an incomplete injury, and most were receiving physiotherapy. All patients who completed the programme increased their time of cycling and, in all but one case, the exercise load, indicative of a local training effect. Significant improvements were found in voluntary isometric strength, stimulated isometric strength and stimulated isometric endurance of the quadriceps, muscle grading of the quadriceps and biceps femoris and the cross-sectional areas of the quadriceps and total thigh muscle. No change was found in voluntary isokinetic strength of the quadriceps. All patients with incomplete injuries reported improvements in the activities of daily living (ADL) after the programme. Bone mineral density (BMD) was examined in two patients, one less than 1 year post injury, and one greater than 4 years post injury. The programme of cycling did not restore BMD in the latter patient. However, while the former patient still displayed a reduced BMD after the programme, it is unknown whether this loss of bone was retarded. This needs further investigation. This study demonstrates the effectiveness of a combined physiotherapy/cycling programme in the rehabilitation of people with spinal injuries. To be successful this type of programme has to be incorporated into the rehabilitation process, as has been done at the Sir George Bedbrook Spinal Unit.
12名患者参与了珀斯皇家康复医院为期3个月的刺激诱导骑行计划。部分患者受伤不到1年，除1人外均为不完全性损伤，且大多数患者正在接受物理治疗。所有完成该计划的患者骑行时间均有所增加，除1例患者外，所有患者的运动负荷也有所增加，这表明存在局部训练效果。研究发现，股四头肌的随意等长肌力、刺激等长肌力和刺激等长耐力、股四头肌和股二头肌的肌肉分级以及股四头肌和大腿总肌肉的横截面积均有显著改善。股四头肌的随意等速肌力未发现变化。所有不完全性损伤的患者在该计划后均报告日常生活活动（ADL）有所改善。对2名患者进行了骨密度（BMD）检查，1名患者受伤不到1年，另1名患者受伤超过4年。骑行计划并未恢复后一名患者的骨密度。然而，尽管前一名患者在该计划后骨密度仍较低，但尚不清楚这种骨质流失是否得到了延缓。这需要进一步研究。本研究证明了物理治疗/骑行联合计划在脊髓损伤患者康复中的有效性。要取得成功，这种类型的计划必须纳入康复过程，就像乔治·贝德布鲁克爵士脊髓治疗中心所做的那样。
