Quantitative analysis of the velocity related pathophysiology of spasticity and rigidity in the elbow flexors
Quantitative analysis of the velocity related pathophysiology of spasticity and rigidity in the elbow flexors
复制标题
DOI：
10.1136/jnnp.72.5.621
复制
发表时间：
2002-05-01
影响因子：
11
通讯作者：
Hwang, IS
中科院分区：
文献类型：
--
作者：
Lee, HM;Huang, YZ;Hwang, IS
目的：量化等速拉伸过程中测得的增加的肌张力的速度依赖性和位置相关特性。方法：对 12 名偏瘫患者、16 名帕金森症患者和 12 名正常对照者，在 75 度的运动范围内以四种不同速度（40、80、120 和 160 度/秒）垂直拉伸肘屈肌。根据反作用扭矩测量，采用线性二阶模型来分离速度相关的粘性分量和速度无关的弹性分量。平均速度相关反射扭矩（ASRT）定义为测量扭矩与基线扭矩的偏差，用于量化张力过高的粘性成分。 ASRT (VASRT) 和分段 ASRT (SASRT) 的速度敏感性分别源自 ASRT 速度图之间回归线的斜率和反作用扭矩的分段，用于区分痉挛和僵直增加的肌张力。 结果：ASRT 和 VASRT 的痉挛和僵直均显着高于正常对照。 SASRT 分析显示痉挛、强直和正常组之间存在三种不同的位置相关模式：痉挛显示相对于位置逐渐增加的肌张力；在整个伸展范围内，刚性增加（相对于正常）但肌张力保持不变；正常对照组在整个范围内始终表现出较低的反作用扭矩。结论：速度依赖性分析表明，僵化和痉挛具有大致相同的速度依赖性特性。为了区分这两种类型的张力亢进，可以采用位置依赖性特性。
Objective: To quantify velocity dependent and position related properties of increased muscle tone measured during a constant velocity stretch.Methods: Elbow flexors were vertically stretched under four different velocities (40, 80, 120, and 160degrees/s) through a 75degrees range of motion in 12 patients with hemiparesis, 16 with parkinsonism, and 12 normal controls. From reactive torque measurement, a linear second order model was adopted to dissociate velocity dependent viscous and velocity independent elastic components. The averaged speed dependent reflex torque (ASRT)-defined as the deviation of measured torque from baseline torque was used to quantify the viscous component of hypertonia. Velocity sensitivity of ASRT (VASRT) and, segmented ASRT (SASRT), derived from the slope of the regression line among ASRT velocity plots and from segmentations of reactive torque, respectively, were used to differentiate the increased muscle tone of spasticity and rigidity.Results: ASRT and VASRT were significantly higher in both spasticity and rigidity than in normal controls. SASRT analysis showed three different position related patterns among spasticity, rigidity, and normal groups: spasticity showed progressively increasing muscle tension relative to position; rigidity showed increased (relative to the norm) but constant muscle tone over the entire stretch range; the normal control group showed a consistently low reactive torque over the entire range.Conclusions: Velocity dependence analysis indicates that rigidity and spasticify have approximately equal velocity dependent properties. For differentiating these two types of hypertonia, position-dependent properties my be employed.