VOLUNTARY MOVEMENT AT THE ELBOW IN SPASTIC HEMIPARESIS
VOLUNTARY MOVEMENT AT THE ELBOW IN SPASTIC HEMIPARESIS
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DOI：
10.1002/ana.410360311
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发表时间：
1994-09-01
影响因子：
11.2
通讯作者：
THILMANN, AF
中科院分区：
文献类型：
--
作者：
FELLOWS, SJ;KAUS, C;THILMANN, AF
在一组单侧缺血性脑损伤引起痉挛的患者（n = 25）中研究了反射亢进和轻瘫在自主臂运动障碍中的相对重要性。对照从正常受试者（n = 15）获得的数据评价患者表现。痉挛患者在屈曲或伸展期间的最大运动速度低于正常受试者。相对于正常受试者的力量，患者手肘屈肌和伸肌的轻瘫越明显，最大速度的降低就越大。然而，对于给定的速度，完成一个动作所需的时间和达到峰值速度的时间是正常的。自主运动受损程度与拮抗肌被动肌张力水平之间无相关性。尽管拮抗肌的过度活动可能在没有相反负荷的情况下以低速进行的运动的干扰中起一定作用，但是在对抗负荷进行的运动期间的拮抗肌活动（即，在更自然的条件下）处于或低于正常水平，即使在那些具有最显著的被动肌张力过高的患者中。结论：在脑卒中后肘关节自主运动障碍中起主导作用的是激动性肌轻瘫，而不是拮抗性肌张力增高。
The relative importance of hyperreflexia and paresis in disturbances of voluntary arm movement was studied in a group of patients (n = 25) with spasticity arising from a unilateral ischemic cerebral lesion. Patient performance was evaluated against data obtained from normal subjects (n = 15). Spastic patients achieved lower maximum movement velocities during flexion or extension than did normal subjects. The more marked the paresis of the elbow flexor and extensor muscles of the patients, relative to the strength of the normal subjects, the greater was this reduction in maximum velocity. For a given velocity, however, the time taken to complete a movement and the time to reach the peak velocity were normal. No relationship was found between the degree of impairment of voluntary movement and the level of passive muscle hypertonia in the antagonist. Although overactivity of the antagonist muscle may play some role in disturbance of movements made at low velocities without an opposing load, antagonist activity during movements made against a load (i.e., under more natural conditions) was at or below normal levels, even in those patients with the most marked passive muscle hypertonia. It is concluded that agonist muscle paresis, rather than antagonist muscle hypertonia, plays the dominant role in the disturbance of voluntary elbow movement following stroke.