Muscle Atrophy and Functional Deficits of Knee Extensors and Flexors in People With Chronic Stroke
Muscle Atrophy and Functional Deficits of Knee Extensors and Flexors in People With Chronic Stroke
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DOI：
10.2522/ptj.20090127
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发表时间：
2012-03-01
期刊：
影响因子：
3.2
通讯作者：
Salvini, Tania F.
中科院分区：
文献类型：
--
作者：
Prado-Medeiros, Christiane L.;Silva, Milla P.;Salvini, Tania F.
背景需要进一步阐明个别肌群的萎缩程度及其与卒中后关节扭矩不足的可能关系。本研究的目的是调查与对照组相比，慢性轻偏瘫患者的股四头肌和腘绳肌的体积和膝关节伸肌和屈肌的力量缺陷。这是一项横断面研究。13名慢性脑卒中偏瘫患者（偏瘫组）和13名健康人（对照组）参加了这项研究。评估运动功能、股四头肌和腘绳肌的体积以及膝关节伸肌和屈肌的最大向心和离心收缩。与对侧（非麻痹）肢体相比，只有麻痹肢体的四头肌显示出肌肉体积减少（24%）。轻偏瘫组和对照组之间的肌肉体积没有差异。与非瘫痪肢体（36%-67%）和对照组（49%-75%）相比，瘫痪肢体膝关节伸肌和屈肌的峰值扭矩在收缩模式和速度上均降低。与对照组相比，非麻痹肢体的伸肌和屈肌峰值扭矩也降低（17%-23%）。功率显示强度类似不足（12%-78%）。运动功能和力量缺陷之间存在显著相关性（0.54 - 0.67）。磁共振成像线圈长度不允许测量大腿近端区域。在仅出现股四头肌萎缩的瘫痪肢体中，股四头肌和腘绳肌的体积反应不同。然而，轻瘫和非轻瘫肢体都显示膝关节伸肌和屈肌扭矩和功率降低。
Background. Further clarification is needed with regard to the degree of atrophy in individual muscle groups and its possible relationship to joint torque deficit poststroke.Objective. The purpose of this study was to investigate quadriceps and hamstring muscle volume and strength deficits of the knee extensors and flexors in people with chronic hemiparesis compared with a control group.Design. This was a cross-sectional study.Methods. Thirteen individuals with hemiparesis due to chronic stroke (hemiparetic group) and 13 individuals who were healthy (control group) participated in this study. Motor function, quadriceps and hamstring muscle volume, and maximal concentric and eccentric contractions of the knee extensors and flexors were assessed.Results. Only the quadriceps muscle of the paretic limb showed reduced muscle volume (24%) compared with the contralateral (nonparetic) limb. There were no differences in muscle volume between the hemiparetic and control groups. The peak torque of the paretic-limb knee extensors and flexors was reduced in both contraction modes and velocities compared with the nonparetic limb (36%-67%) and with the control group (49%-75%). The nonparetic limb also showed decreased extensor and flexor peak torque compared with the control group (17%-23%). Power showed similar deficits in strength (12%-78%). There were significant correlations between motor function and strength deficits (.54-.67).Limitations. Magnetic resonance imaging coil length did not allow measurement of the proximal region of the thigh.Conclusions. There were different responses between quadriceps and hamstring muscle volumes in the paretic limb that had quadriceps muscle atrophy only. However, both paretic and nonparetic limbs showed knee extensor and flexor torque and power reduction.