Effect of pedaling exercise on the hemiplegic lower limb
Effect of pedaling exercise on the hemiplegic lower limb
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DOI：
10.1097/01.phm.0000064722.01940.e4
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发表时间：
2003-05-01
影响因子：
3
通讯作者：
Chino, N
中科院分区：
文献类型：
--
作者：
Fujiwara, T;Liu, MG;Chino, N
目的：探讨步行训练对脑卒中偏瘫患者肢体肌肉活动的影响。设计：17例非卧床慢性脑卒中偏瘫患者进行前后对照研究。使用带有后备箱支撑的伺服动态控制测功器，患者以舒适的速度以5N-m的阻力骑行。用双侧股四头肌、股四头肌、胫骨前肌和腓肠肌内侧的表面电极记录肌肉活动，并用积分肌电图仪分析踏板周期中的肌肉活动模式。比较蹬前、踏后即刻和踏后30min患肢主动伸膝时的肌肉活动。结果：我们发现患肢在踏板时的肌肉活动与健侧相反。与主动伸膝时相比，踏板时股四头肌和胫前肌的肌肉活动显著增加，而内侧腿筋的肌肉活动无明显变化。主动伸膝时股四头肌和胫前肌的踏后促进和腓肠肌的抑制至少持续30min。结论：即使是重度偏瘫患者，踏踏也能促进肌肉的相位性和协调性活动，是一种有效的肌肉再教育模式。
Objective: To assess the effects of pedaling exercise on the muscle activities in hemiparetic lower limbs in patients with stroke.Design: In this before-and-after trial, 17 nonambulatory patients with chronic hemiparetic stroke were recruited. Using a servo-dynamically controlled ergometer with a trunk support, the patients pedaled at a resistance of 5 N-m at their comfortable speeds. Muscle activities were recorded with surface electrodes from bilateral quadriceps femoris, media[ hamstrings, tibialis anterior, and medial gastrocnemius, and integrated electromyograms were used for analysis of muscle activity patterns during the pedaling cycle. Muscle activities during pedaling were compared with those during voluntary knee extension of the affected limb before, immediately after, and 30 min after the pedaling.Results: We found phasic muscle activities in the affected limb during pedaling that were antiphasic to the contralateral side. The muscle activities of quadriceps femoris and tibialis anterior increased significantly during pedaling compared with those during voluntary knee extension effort, whereas the muscle activity of medial hamstrings did not change. The postpedaling facilitation of quadriceps and tibialis anterior and the inhibition of gastrocnemius during voluntary knee extension effort lasted at least for 30 min.Conclusion: Pedaling could facilitate phasic and coordinated muscle activities even in patients with severe hemiparesis, and it is potentially an effective mode of muscle reeducation.