Noreau L, Shephard R J, Simard C, Paré G, Pomerleau P
Department of Physiotherapy, Laval University, Québec City.
Int J Rehabil Res. 1993 Dec;16(4):265-75. doi: 10.1097/00004356-199312000-00002.
Associations between a physically active leisure, physical fitness, impairment and disability have been tested in 123 volunteers (73 with paraplegia and 50 with quadriplegia). Active physical leisure was assessed by the questionnaire of Godin and Shephard (Canadian Journal of Sports Sciences 10, 141-6 1985). Fitness measures included body mass index, peak oxygen intake on a wheelchair ergometer, and tests of muscle strength and endurance (peak isokinetic torque, average muscle power and total muscle work for shoulder flexion, shoulder adduction and elbow flexion at movement speeds of 60 degrees and 180 degrees s-1). Primary impairment was assessed by the ISMGF scale, and secondary impairment was judged from reported pressure scores, spasticity, and urinary infections over the previous 12 months. Scores for self-care and mobility were obtained using a modified Barthel Index. Physically active leisure and fitness were unrelated to secondary impairment. However, functional ability for a given primary impairment was significantly correlated with peak oxygen intake and the three indices of muscle strength, particularly in individuals with high level lesions. Associations between physical activity and functional ability were weaker, but tended in the same direction. Although longitudinal studies are needed to prove the causality of these relationships, the findings point towards a significant influence of fitness status upon functional ability. Rehabilitation teams should thus give a stronger emphasis to systematic exercise conditioning programmes when planning overall treatment following SCI.
在123名志愿者（73名截瘫患者和50名四肢瘫患者）中测试了积极的休闲活动、身体素质、损伤与残疾之间的关联。通过戈丁和谢泼德问卷（《加拿大运动科学杂志》10, 141 - 146, 1985年）评估积极的休闲活动。健康指标包括体重指数、轮椅测力计上的峰值摄氧量，以及肌肉力量和耐力测试（60度/秒和180度/秒运动速度下肩屈曲、肩内收和肘屈曲的峰值等速扭矩、平均肌肉功率和总肌肉功）。通过ISMGF量表评估原发性损伤，根据过去12个月报告的压力评分、痉挛和泌尿系统感染判断继发性损伤。使用改良的巴氏指数获得自理和活动能力评分。积极的休闲活动和身体素质与继发性损伤无关。然而，给定原发性损伤的功能能力与峰值摄氧量和三个肌肉力量指标显著相关，尤其是在高位损伤的个体中。身体活动与功能能力之间的关联较弱，但趋势相同。尽管需要纵向研究来证明这些关系的因果性，但研究结果表明健康状况对功能能力有显著影响。因此，康复团队在计划脊髓损伤后的整体治疗时，应更加强调系统的运动训练计划。
