Poststroke muscle architectural parameters of the tibialis anterior and the potential implications for rehabilitation of foot drop.
Poststroke muscle architectural parameters of the tibialis anterior and the potential implications for rehabilitation of foot drop.
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DOI：
10.1155/2014/948475
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发表时间：
2014
影响因子：
1.5
通讯作者：
Higginson JS
中科院分区：
文献类型：
--
作者：
Ramsay JW;Wessel MA;Buchanan TS;Higginson JS
中风后背屈肌无力和瘫痪肢体足部下垂增加了跌倒和跌倒的风险，并降低了整体功能活动能力。令人感兴趣的是，背屈肌无力是否主要源于神经系统，或者形态差异是否也是造成这种损害的原因。使用非侵入性医学成像技术对10名中风后偏瘫患者进行了双侧成像。用磁共振成像来确定胫前肌体积和肌腹长度的变化。中立位超声测量肌束长度和羽状角。我们发现所有受试者在任何结构参数上都没有临床上有意义的双侧差异，这表明这些受试者有肌肉能力来背屈他们的脚。因此，卒中后背屈肌无力主要是神经性的，可能是由于肌肉激活失败或足底屈肌痉挛增加所致。目前的发现表明，电刺激方法或额外的神经肌肉再训练可能比以肌肉力量为目标(即增加肌肉质量)更有益。
Poststroke dorsiflexor weakness and paretic limb foot drop increase the risk of stumbling and falling and decrease overall functional mobility. It is of interest whether dorsiflexor muscle weakness is primarily neurological in origin or whether morphological differences also contribute to the impairment. Ten poststroke hemiparetic individuals were imaged bilaterally using noninvasive medical imaging techniques. Magnetic resonance imaging was used to identify changes in tibialis anterior muscle volume and muscle belly length. Ultrasonography was used to measure fascicle length and pennation angle in a neutral position. We found no clinically meaningful bilateral differences in any architectural parameter across all subjects, which indicates that these subjects have the muscular capacity to dorsiflex their foot. Therefore, poststroke dorsiflexor weakness is primarily neural in origin and likely due to muscle activation failure or increased spasticity of the plantar flexors. The current finding suggests that electrical stimulation methods or additional neuromuscular retraining may be more beneficial than targeting muscle strength (i.e., increasing muscle mass).