Multijoint reflexes of the stroke arm: neural coupling of the elbow and shoulder.
Multijoint reflexes of the stroke arm: neural coupling of the elbow and shoulder.
复制标题
划水臂的多关节反射：肘部和肩部的神经耦合。
DOI：
10.1002/mus.20852
复制
发表时间：
2007
期刊：
影响因子：
3.4
通讯作者：
Schmit,BrianD
中科院分区：
文献类型：
--
作者：
Sangani,SamirG;Starsky,AndrewJ;McGuire,JohnR;Schmit,BrianD
在16名单侧中风患者和6名神经功能完好的对照者中，测量手肘和肩对痉挛肘完全舒适范围的恒定速度角伸展的反射扭矩反应，以确定中风后发生的关节间反射耦合。由此产生的反应显示了大量的反射扭矩在手肘和肩部中风的科目，16名受试者中的12个产生内收的肩膀，以响应手肘的被动伸展。肩关节屈曲力矩与肘关节屈曲力矩同时存在，并且波形相同，表明双关节肘/肩屈肌（如二头肌）的积极作用。由于二头肌产生肩部外展力矩，因此肘部伸展期间产生的肩部内收被认为与神经而不是生物力学耦合有关。这些结果表明，中风患者的痉挛状态比传统的过度兴奋牵张反射更为复杂，并且包括有效的异源反射通路。在痉挛的诊断和临床治疗中应考虑肩肘之间的反射耦合。这种反射对手臂自主运动协调的潜在影响将在未来的研究中进行研究。肌肉神经，2007年
The reflex torque responses of the elbow and shoulder to constant velocity angular extensions of the full comfortable range of the spastic elbow were measured in 16 people with unilateral stroke and 6 neurologically intact controls in order to identify the interjoint reflex coupling that occurs after stroke. The resulting responses showed a substantial reflex torque at the elbow and shoulder in subjects with stroke, with 12 of the 16 subjects producing adduction of the shoulder in response to passive extension of the elbow. The presence of simultaneous shoulder flexion torque with elbow flexion torque and with an identical waveform indicated an active role of biarticular elbow/shoulder flexors, such as the biceps. As the biceps muscle produces a shoulder abduction moment, shoulder adduction produced during elbow extension was thought to be associated with neural rather than biomechanical coupling. These results suggest that spasticity in people with stroke is more complex than its traditional perception as a hyperexcitable stretch reflex, and includes potent heteronymous reflex pathways. The reflex coupling observed between the shoulder and elbow should be considered in the diagnosis and clinical management of spasticity. The potential impact of this reflex on the coordination of volitional arm movements will be examined in future studies. Muscle Nerve, 2007