Dickstein R, Zaslanski R, Heffes Y, Mizrachi E, Shabtai E L, Abulaffio N
Flieman Geriatric Rehabilitation Hospital, Haifa, Israel.
Arch Phys Med Rehabil. 1997 Oct;78(10):1125-8. doi: 10.1016/s0003-9993(97)90139-8.
To examine the association between stance ability and walking performance of poststroke hemiplegic patients and their posterior tibial nerve somatosensory evoked potentials (SEPs).
Fifteen patients, residents of a geriatric rehabilitation hospital, were evaluated twice, with a 2-week interval between sessions. In each session, clinical tests of stance balance and walking ability were performed, and bilateral SEPs to stimulation of the posterior tibial nerve were recorded. Eight healthy, age-matched control subjects underwent the same tests in a single session, but SEPs were recorded unilaterally. Correlation analysis and analysis of variance (ANOVA) were used for studying the prognostic value of the initial posterior tibial nerve SEP measurements as well as the within- and between-sessions relationships between the clinical-functional tests and the SEP data.
No significant correlations between the initial SEP values and functional improvement were established. Within each session, positive significant correlations existed between decreased latencies of several of the medium-latency SEP waves and the performance of stance and gait tasks. However, the between-sessions improvement in stance balance was not correlated with a decrease in latency of the SEP peaks or with an increase in their amplitudes. As to walking ability, in those patients whose gait significantly improved, a significant shortening of P37 and P54 latencies took place.
The association between the initial and/or the 2-week changes in SEP of the posterior tibial nerve and improvement in stance and walking abilities is equivocal. In addition, the applicability of SEP measurements is limited by patients' physical status and cooperation. The clinical significance of posterior tibial nerve SEP testing in poststroke hemiparetic patients is therefore debatable.
研究脑卒中后偏瘫患者的站立能力与步行表现及其胫后神经体感诱发电位（SEP）之间的关联。
15名老年康复医院的患者接受了两次评估，两次评估间隔2周。每次评估时，进行了站立平衡和步行能力的临床测试，并记录了双侧胫后神经刺激的SEP。8名年龄匹配的健康对照受试者在单次评估中接受了相同测试，但SEP仅单侧记录。采用相关分析和方差分析（ANOVA）来研究初始胫后神经SEP测量的预后价值，以及临床功能测试与SEP数据在各次评估之间和各次评估内的关系。
初始SEP值与功能改善之间未建立显著相关性。在每次评估中，几个中潜伏期SEP波潜伏期的缩短与站立和步态任务的表现之间存在显著正相关。然而，各次评估间站立平衡的改善与SEP波峰潜伏期的缩短或波幅的增加无关。至于步行能力，在步态显著改善的患者中，P37和P54潜伏期显著缩短。
胫后神经SEP的初始和/或2周变化与站立和步行能力改善之间的关联不明确。此外，SEP测量的适用性受患者身体状况和合作程度的限制。因此，胫后神经SEP测试在脑卒中后偏瘫患者中的临床意义存在争议。
