Task-dependent weakness at the elbow in patients with hemiparesis
Task-dependent weakness at the elbow in patients with hemiparesis
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DOI：
10.1016/s0003-9993(99)90225-3
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发表时间：
1999-07-01
影响因子：
4.3
通讯作者：
Dewald, JPA
中科院分区：
文献类型：
--
作者：
Beer, RF;Given, JD;Dewald, JPA
目的：研究轻偏瘫患者肘关节无力的任务依赖性。设计：描述性研究，基于在四种任务条件下肘关节屈曲和伸展时等距产生的最大随意扭矩（MVT）的肢体间比较：没有明确控制相邻关节的扭矩，并结合三个次最大肩外展内收扭矩水平。设置：康复中心研究实验室。患者：6名慢性轻偏瘫患者和4名对照的志愿者样本。主要结果测量：残余强度（RS），定义为患者的轻瘫和非轻瘫肢体以及对照的非优势和优势肢体的MVT比率。结果：对于患者组，发现任务条件对RS有显著影响（方差分析，肘关节屈曲和伸展分别为p = 0.0003和p = 0.002）。随着肩关节外展力矩水平的增加，屈肘RS增加，伸肘RS减少。与此相反，对于对照组，RS的任务条件的效果是不显着的。结论：在偏瘫患者，瘫痪肘肌肉组织的弱点表现出很强的任务依赖性。这种任务依赖性可能反映了瘫痪肢体的肘和肩肌肉之间存在异常协同作用，并对轻偏瘫后运动功能的康复具有重要意义。(C)1999年由美国康复医学大会和美国物理医学与康复学会主办。
Objective: To investigate the task dependence of elbow weakness in patients with hemiparesis.Design: Descriptive study based on interlimb comparisons of maximum voluntary torques (MVTs) generated isometrically in elbow flexion and extension under four task conditions: without explicit control of the torques at adjacent joints and in combination with each of three submaximal shoulder abduction adduction torque levels.Setting: Rehabilitation center research laboratory.Patients: Volunteer samples of six patients with chronic hemiparesis and four controls.Main Outcome Measure: Residual strength (RS), defined as the ratio of MVTs for the paretic and nonparetic limbs of patients and nondominant and dominant limbs of controls.Results: For the patient group a significant effect of task condition on RS was found (analysis of variance, p = .0003 and p = .002 for elbow flexion and extension, respectively). With increasing shoulder abduction torque level, elbow flexion RS increased and elbow extension RS decreased. In contrast, for the control group, the effect of task condition on RS was not significant.Conclusion: In hemiparetic patients, weakness of the paretic elbow musculature shows a strong task dependence. This task dependence likely reflects the existence of abnormal synergies between elbow and shoulder muscles of the paretic limb and has important implications for the rehabilitation of motor function following hemiparesis. (C) 1999 by the American Congress of Rehabilitation Medicine ann the American Academy of Physical Medicine and Rehabilitation.