Quadriceps muscle weakness following acute hemiplegic stroke
Quadriceps muscle weakness following acute hemiplegic stroke
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DOI：
10.1191/026921501669958740
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发表时间：
2001-06-01
影响因子：
3
通讯作者：
Moxham, J
中科院分区：
文献类型：
--
作者：
Harris, ML;Polkey, MI;Moxham, J
目的：确定急性缺血性偏瘫卒中后第一周内，脑损伤同侧是否出现股四头肌无力。设计：一项肌肉力量的前瞻性研究。设置：教学医院的急性卒中单元（ASU）。受试者：10名卒中发作48小时内入院的患者，10名年龄匹配的健康对照。干预措施：使用磁股神经刺激（MS），前瞻性间隔一周，重复非自主测量患者未受影响肢体和正常受试者右腿的股四头肌肌力。此外，在最大自主收缩（MVC）动作期间评估自主激活水平。对患者进行躯干控制测试（TCT）。中位数（95%置信区间，（CI））对照组的基线股四头肌收缩张力（Tw Q）和MVC为9.4 kg中风组分别为7.6 kg（4.4 - 9.9 kg）和12.15 kg（7.9 - 30.8 kg）。对照组Tw Q和MVC的中位数（95% CI）分别为1.75%（-9.8至8%）和5.45%（-15.1至22.7%）（NS），脑卒中组分别为-16.2%（-6至25.9%）和-30.45%（0至-78.6%）（p <0.01）。Tw Q下降百分比与TCT变化（r（s）= 0.83，p <0.01）和体重变化百分比（r（s）= 0.83，p <0.01）均呈显著相关。
Objective: To determine whether quadriceps muscle weakness develops on the side ipsilateral to the brain lesion in the first week following acute ischaemic hemiplegic stroke.Design: A prospective study of muscle strength.Setting: Acute stroke unit (ASU) in a teaching hospital.Subjects: Ten patients admitted within 48 hours of stroke onset, and 10 healthy age-matched controls.Interventions: Repeat nonvolitional measurements of quadriceps muscle strength of the unaffected limb in patients and the right leg in normal subjects using magnetic femoral nerve stimulation (MS), prospectively one week apart. In addition the level of voluntary activation was assessed during a maximum voluntary contraction (MVC) manoeuvre. The Trunk Control Test (TCT) was measured in the patients.Results: The median (95% confidence interval, (CI)) baseline quadriceps twitch tension (Tw Q) and MVC in the control group were 9.4 kg (6.1-12.5 kg) and 37.2 kg (23.8-54.6 kg), and in the stroke group were 7.6 kg (4.4-9.9 kg) and 12.15 kg (7.9-30.8 kg). The median (95% CI) change in Tw Q and MVC respectively between baseline and one week later were 1.75% (-9.8 to 8%) and 5.45% (-15.1 to 22.7%) (NS) in the control group and -16.2% (-6 to -25.9%) and -30.45% (0 to -78.6%) (p < 0.01) in the stroke patients. There was a significant correlation between the percentage fall in Tw Q and both change in TCT (r(s) = 0.83, p < 0.01) and percentage change in body weight (r(s) = 0.83, p < 0.01).Conclusion: In the first week after acute hemiplegic stroke, weakness develops in the unaffected leg.