Upper and lower motor neuron lesions in the upper extremity muscles of tetraplegics
Upper and lower motor neuron lesions in the upper extremity muscles of tetraplegics
复制标题
四肢瘫痪者上肢肌肉的上下运动神经元病变
DOI：
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发表时间：
1976
期刊：
影响因子：
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通讯作者：
E. Marsolais
中科院分区：
文献类型：
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作者：
P. Peckham;J. Mortimer;E. Marsolais
对24例四肢瘫痪患者的上肢肌肉进行了检查，以确定其下运动神经元是否完整。主要重点放在前臂手指屈肌（指浅屈肌和指深屈肌）和手指伸肌（指总伸肌和指伸肌）上。结果发现，在C4，C5和C6受试者的这些肌肉中的绝大多数保留了部分或全部的下运动神经元完好无损。在C5受试者中，对额外的肌肉进行检查，这些肌肉在利用功能刺激的矫形器中可能是最有用的。与手指屈肌和伸肌的结果类似，手腕和拇指的肌肉通常具有至少部分完整的下运动神经元。有一种肌肉是例外，那就是M。桡侧腕屈肌：这些研究表明，高位脊髓损伤瘫痪患者上肢的前臂肌肉大多数具有完全或部分完整的下运动神经元。通过电诱导运动，这些肌肉被加强到收缩的功能水平。随后的电激活使四肢瘫痪患者能够功能性地使用肌肉。
Paralysed upper extremity muscles of 24 tetraplegie patients were examined to determine whether their lower motor neuron was intact. Primary emphasis was placed on the forearm finger flexor muscles (Flexor Digitorum Superficialis and Flexor Digitorum Profundus) and finger extensor muscles (Extensor Digitorum Communis and Extensor Indicis). It was found that the vast majority of these muscles in C4, C5 and C6 subjects retained some or all of their lower motor neurons intact.In C5 subjects, examination was performed on additional muscles that were potentially most useful in an orthosis utilising functional stimulation. Similar to the results of the finger flexor and extensor muscles, the muscles of the wrist and thumb generally had the lower motor neuron at least partially intact. A muscle that often was an exception was M. Flexor Carpi Radialis.These studies indicate that most of the forearm muscles of the upper extremity in high level spinal cord injury patients which are paralysed have the lower motor neuron totally or partially intact. With electrically induced exercise, such muscles are strengthened to functional levels of contraction. Subsequent electrical activation enables the quadriplegic patients to use the muscle functionally.