Abductor hallucis for monitoring lower-limb recovery after spinal cord injury in man
Abductor hallucis for monitoring lower-limb recovery after spinal cord injury in man
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DOI：
10.1038/sj.sc.3101640
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发表时间：
2004-10-01
期刊：
影响因子：
2.2
通讯作者：
Broton, JG
中科院分区：
文献类型：
--
作者：
Calancie, B;Molano, MR;Broton, JG
研究设计：对急性脊髓损伤（SCI）患者的肌电图（EMG）研究。目的：根据皮质脊髓束神经支配对这些不同运动神经元池的相对密度，我们假设轻度至中度急性SCI受试者与更近端的下肢肌肉相比，足部内在肌功能恢复的可能性更高。设置：美国迈阿密和锡拉丘兹。方法：我们对急性创伤性脊髓损伤患者下肢肌肉自主收缩过程中的肌电图进行了重复测量。对于本研究，分析仅限于初始评价期间任一下肢肌肉无募集（即“运动完全”）或募集受限（即“运动不完全”）的受试者，并且在最终评价时所有受试者的一条或两条腿均转换为运动不完全状态。招聘的外展拇（AbH）肌肉在收缩尝试被判断为“存在”或“缺席”，根据存在或不存在的基于EMG的意志运动单元recruitment.Results：共70例被列入本研究。其中，58例在T10椎体节段或吻侧有运动不完全损伤，另外12例在T10椎体节段尾侧有损伤。在前一组中，AbH肌肉的恢复概率大大高于其他下肢肌肉。在T10尾侧损伤的患者中观察到完全相反的模式。在这些科目中，招聘是更常见的大腿近端肌肉（腰肌和四头肌），最不常见的AbH muscle.Discussion：对于SCI的人在或喙T10椎体水平，AbH肌肉被证明是一个早期和更敏感的指标下肢收缩恢复急性SCI后相比，其他下肢肌肉。将这种足部固有肌作为SCI后肌肉功能的神经学评估的一部分，应增加测试对保留（或恢复）的脊髓上运动对下肢运动神经元池的影响的敏感性，并且是推荐的。
Study design: Electromyogram (EMG) study on patients with acute spinal cord injury (SCI).Objectives: We hypothesized that subjects with mild to moderate acute SCI would have a higher probability of recovering function in intrinsic muscles of the foot compared to more proximal lower-limb muscles, based on the relative density of corticospinal tract innervation to these different motoneuron pools.Setting: Miami and Syracuse, USA.Methods: We conducted repeated measures of EMG during voluntary contractions from lower-limb muscles in subjects with acute traumatic SCI. For this study, analysis was restricted to those subjects who had either no recruitment (ie 'motor-complete') or limited recruitment (ie 'motor-incomplete') in any lower-limb muscle of either leg during the initial evaluation, and all of whom had converted to a motor-incomplete status in one or both legs at the time of final evaluation. Recruitment of the abductor hallucis (AbH) muscle during contraction attempts was judged as being either 'present' or 'absent', based upon the presence or absence of EMG-based volitional motor unit recruitment.Results: A total of 70 subjects were included in this study. Of these, 58 had motor-incomplete injury at or rostral to the T10 vertebral level, and another 12 had injury caudal to T10. In the former group, the AbH muscle showed a recovery probability that was considerably higher than that of other lower-limb muscles. Quite the opposite pattern was seen in persons with injury caudal to T10. In these subjects, recruitment was more common in proximal muscles of the thigh (psoas and quadriceps), and least common in the AbH muscle.Discussion: For persons with SCI at or rostral to the T10 vertebral level, the AbH muscle proved to be an earlier and more sensitive indicator of lower-limb contraction recovery following acute SCI compared to other lower-limb muscles. Including this intrinsic muscle of the foot as part of a neurologic assessment of muscle function after SCI should increase the test's sensitivity to preserved (or restored) supraspinal motor influence over lower-limb motoneuron pools, and is recommended.