Relationship between spinal reflexes and leg motor function in sub-acute and chronic stroke patients
Relationship between spinal reflexes and leg motor function in sub-acute and chronic stroke patients
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亚急性和慢性脑卒中患者脊髓反射与腿部运动功能的关系
DOI：
10.1016/j.clinph.2022.02.025
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发表时间：
2022
影响因子：
4.7
通讯作者：
Meigen Liu
中科院分区：
文献类型：
--
作者：
Yoko Takahashi;Michiyuki Kawakami;Rena Mikami;Toshiya Nakajima;Towa Nagumo;Tomofumi Yamaguchi;Kaoru Honaga;Kunitsugu Kondo;Ryota Ishii;Toshiyuki Fujiwara;Meigen Liu
目的探讨亚急性脑卒中（SAS）和慢性脑卒中（CS）患者脊髓反射与运动功能的关系。采用Fugl-Meyer低血糖量表（FMA-LE）和改良Ashworth量表（MAS）进行评估。脊髓反射和运动功能之间的关系进行了检查，在横截面的方式。SAS患者进行了纵向评估之前和之后的强化康复约2 months.ResultsSAS患者小腿三头肌痉挛（MAS ≥ 1）表现出较高的HF值（P = 0.03）比那些没有痉挛。SAS患者股四头肌痉挛时HF值显著高于无痉挛者（p < 0.01），腘绳肌痉挛时DRI值显著高于无痉挛者（p < 0.01）。CS患者的脊髓反射与运动功能之间无显著相关性。纵向研究显示，SAS患者的D1抑制和FMA-LE改善增加之间存在显著相关性（r = 0.69）。结论脊髓反射受损之间的关联与中风的阶段不同; HF和DRI可能是SAS患者痉挛的指标。
ObjectiveTo assess the relationship between spinal reflexes and motor function in sub-acute (SAS) and chronic stroke (CS) patients.MethodsTwelve SAS and 16 CS patients underwent electrophysiological assessment of heteronymous facilitation (HF), heteronymous inhibition (HI), disynaptic reciprocal inhibition (DRI), and D1 inhibition (D1). The Fugl-Meyer Assessment Lower Extremity (FMA-LE) and modified Ashworth scale (MAS) were assessed. The relationship between spinal reflexes and motor function was examined in a cross-sectional manner. SAS patients were also longitudinally evaluated before and after intensive rehabilitation for approximately 2 months.ResultsSAS patients with triceps surae muscle spasticity (MAS ≥ 1) showed higher HF values (p = 0.03) than those without spasticity. SAS patients with quadriceps muscle spasticity showed higher HF values (p < 0.01); patients with hamstring muscle spasticity showed higher DRI value (disinhibition) (p < 0.01) than those without spasticity. CS patients showed no significant correlation between spinal reflexes and motor function. The longitudinal study revealed a significant correlation between increase in D1 inhibition and FMA-LE improvement in SAS patients (r = 0.69).ConclusionsThe association between impaired spinal reflexes varies with the stage of stroke; HF and DRI may be spasticity indicators in SAS patients.SignificanceSpinal reflexes as potential biomarkers may facilitate tailor-made rehabilitation of stroke patients.
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