Enhanced spinal excitation from ankle flexors to knee extensors during walking in stroke patients
Enhanced spinal excitation from ankle flexors to knee extensors during walking in stroke patients
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DOI：
10.1016/j.clinph.2009.12.037
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发表时间：
2010-06-01
影响因子：
4.7
通讯作者：
Marchand-Pauvert, V.
中科院分区：
文献类型：
--
作者：
Achache, V.;Mazevet, D.;Marchand-Pauvert, V.
目的：目前尚不清楚反射活动改变在多大程度上会导致中风后的步态缺陷。方法：早期对腓总神经(CPN)进行电刺激，对14例卒中患者以0.6~1.6 km/h的速度步行，14例对照组以3.2~4.8和1 km/h的速度行走的股四头肌运动神经元的短潜伏期双相肌电活动进行检测。结果：CPN诱发的双相易化肌电活动出现第二个峰值，结论：卒中后步行过程中，患者偏瘫侧较非瘫痪侧或对照组的兴奋程度更大。结论：中风后步行过程中，可能是由于下行控制的可塑性适应，患者的腰背肌对膝关节伸肌的兴奋增强。意义：当患者恢复踝背屈功能时，这种适应可能有助于膝关节在早期站立。2010年国际临床神经生理学联合会。爱思唯尔爱尔兰有限公司出版。版权所有。
Objectives: It is still unclear to what an extent altered reflex activity contributes to gait deficit following stroke. Spinal group I and group II excitations from ankle dorsiflexors to knee extensors were investigated during post-stroke walking.Methods: Electrical stimulation was applied to the common peroneal nerve (CPN) in the early stance, and the short-latency biphasic excitation in Quadriceps motoneurones was evaluated from the Vastus Lateralis (VL) rectified and averaged (N = 50) EMG activity in 14 stroke patients walking at 0.6-1.6 km/h, and 14 control subjects walking at 3.2-4.8 and at 1 km/h.Results: The second peak of the CPN-induced biphasic facilitation in VL EMG activity, which is likely mediated by group II excitatory pathways, was larger on the paretic side of the patients, as compared to their nonparetic side or control subjects, whatever their walking speed.Conclusions: The spinal, presumed group II, excitation from ankle dorsiflexors to knee extensors is particularly enhanced during post-stroke walking probably due to plastic adaptations in the descending control.Significance: This adaptation may help to stabilize the knee in early stance when the patients have recover ankle dorsiflexor functions. C() 2010 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.