Relationship between joint motion and flexor tendon force in the canine forelimb
Relationship between joint motion and flexor tendon force in the canine forelimb
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DOI：
10.1016/s0363-5023(96)80299-1
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发表时间：
1996-11-01
影响因子：
1.9
通讯作者：
Gelberman, RH
中科院分区：
文献类型：
--
作者：
Lieber, RL;Amiel, D;Gelberman, RH
为了增加屈肌腱修复后的体内肌腱力量和滑动，已经提倡对实施保护性被动运动的方法进行各种修改。为了确定主要变量、手腕和手指位置、肌肉激活和体内肌腱力之间的关系，开发了临床相关的犬模型。在几种关节操作范例中测量屈肌腱的力：手腕弯曲的单指屈曲-伸展（组1F）、手腕伸展的单指屈曲-伸展（1E组）、手腕弯曲的四指屈曲-伸展（4F组）、手腕伸展的四指屈曲-伸展（4E组）以及手腕伸展和手指弯曲的协同手腕和手指运动同时进行手腕屈曲和手指伸展（SYN 组）。此外，在电刺激近端屈肌群期间测量肌腱力。手腕伸展时的被动肌腱力（第 1E 组和第 4E 组）比手腕弯曲时测量的被动肌腱力大两到三倍，与移动的手指数量无关。手腕伸展时，在单位数操作期间，峰值肌腱力达到 1,977 g +/- 194 g（第 1E 组），而在相同操作过程中，手腕弯曲时，峰值肌腱力仅为 853 g +/- 104 g（第 1 F1 组）。平均值之间的统计比较显示，1E 组和 4E 组与 1F、4F 和 SYN 组显着不同（p < .005）。 1E 组和 4E 组之间或 1F、4F 和 SYN 组之间的差异 (p > .200) 当手腕从完全伸展 3460 g +/- 766 g 弯曲到完全弯曲 427 g +/- 239 g (p < .001) 时，主动肌肉力量发生显着变化。同时，被动张力从 940 g +/- 143 g 下降。手腕弯曲时手腕伸展至 76 g +/- 37 g。这些数据表明，在常用于康复屈肌腱修复的运动中，手腕位置对屈肌腱力的影响最大，因此，如果在被动运动期间控制力，则腕关节角度将具有主导作用，而操作的手指数量的影响要小得多。如果目标是增加肌腱力量，康复可以包括使用更大程度的手腕伸展的锻炼计划。
To increase in vivo tendon force and gliding after flexor tendon repair, a variety of modifications to the methods by which protective passive motion is administered have been advocated. To determine the relationship between the prime variables, wrist and digital position, muscle activation, and in vivo tendon force, a clinically relevant canine model was developed. Force was measured in the flexor tendon during several joint manipulation paradigms: single-finger flexion-extension with the wrist flexed (group 1F), single-finger flexion-extension with the wrist extended (group 1E), four-finger flexion-extension with the wrist flexed (group 4F), four-finger flexion-extension with the wrist extended (group 4E), and synergistic wrist and finger motion where wrist extension and finger flexion were performed simultaneously, followed by wrist flexion and finger extension (group SYN). In addition, tendon force was measured during electric stimulation of the proximal flexor muscle mass. Passive tendon force with the wrist extended (groups 1E and 4E) was two to three times greater than that measured with the wrist flexed, independent of the number of digits moved. With the wrist extended, peak tendon force reached 1,977 g +/- 194 g during single-digit manipulation (group 1E), compared to only 853 g +/- 104 g with the wrist flexed dur ing the same maneuver (group 1 Fl. Statistical comparison between means revealed that groups 1E and 4E were significantly different from groups 1F, 4F, and SYN (p < .005). There were no significant differences between groups 1E and 4E or between groups 1F, 4F, and SYN (p > .200). Active muscle force elicited by electrical stimulation and passive force varied dramatically as the wrist was flexed from full extension 3460 g +/- 766 g to full flexion 427 g +/- 239 g (p < .001). Simultaneously, passive tension decreased from 940 g +/- 143 g with wrist extended to 76 g +/- 37 g with the wrist flexed. These data indicate that wrist position has the greatest effect on flexor tendon force during motions that are commonly used to rehabilitate flexor tendon repairs. Thus, if force is to be controlled during passive motion, wrist-joint angle will have the dominant effect, while the number of digits manipulated will have much less of an effect. If the clinical goal is to minimize tendon force, rehabilitation could be carried out with the wrist flexed, whereas if the goal is to increase tendon force, rehabilitation could include exercise programs that use a greater degree of wrist extension.