脑卒中偏瘫患者肩肘关节在等长性收缩运动中的力量控制

doi:10.3969/j.issn.1006-9771.2017.01.019

《中国康复理论与实践》 ›› 2017, Vol. 23 ›› Issue (1): 81-84.doi: 10.3969/j.issn.1006-9771.2017.01.019

脑卒中偏瘫患者肩肘关节在等长性收缩运动中的力量控制

赵晨钰¹, 毕胜², 卢茜³

1.解放军医学院,北京市 100853;
2.解放军总医院康复科,北京市 100853;
3.中日友好医院,北京市 100029

收稿日期:2016-10-27 出版日期:2017-01-20 发布日期:2017-02-17
作者简介:赵晨钰(1989-),女,汉族,河北保定市人,硕士研究生,主要研究方向：神经康复。通讯作者：毕胜,主任医师,教授。E-mail: bisheng301@gmail.com。
基金资助:
国家自然科学基金项目(No.81272162)

Force Control of Elbow and Shoulder during Isometric Contraction in Hemiparetic Stroke Patients

ZHAO Chen-yu¹, BI Sheng², LU Xi³

1. Chinese PLA Medical School, Beijing 100853, China;
2. Department of Rehabilitation Medicine, Chinese PLA General Hospital, Beijing 100853, China;
3. China-Japan Friendship Hospital, Beijing 100029, China

Received:2016-10-27 Published:2017-01-20 Online:2017-02-17
Contact: BI Sheng. E-mail: bisheng301@gmail.com

摘要/Abstract

摘要： 目的评价慢性期脑卒中患者肩关节和肘关节在等长性收缩运动中的力量控制能力。方法 2015年1月至12月,22例慢性脑卒中患者及12名健康对照者,采用手臂静力力量测量仪器测量在肩外展、内收和肘屈曲、伸展4组动作下的最大力量,计算变异系数。结果脑卒中患者上肢最大力量低于健康人(t>2.349, P<0.05),除肘伸展外,变异系数也增加(t>1.974, P<0.05)。结论通过力量测试及变异系数的计算,能客观反映脑卒中患者肩肘运动的控制能力。

关键词: 脑卒中, 偏瘫, 肩, 肘, 等长性收缩, 力量控制

Abstract: Objective To evaluate the ability of force control of elbow and shoulder during isometric contraction in patients with chronic stroke. Methods From January to December, 2015, 22 chronic stroke patients and 12 healthy people were measured the maximum force during shoulder abduction/adduction and elbow flexion/extension with instrument for measuring force of upper extremity. The coefficient of variation was calculated. Results The maximum force was less in the patients than in the healthy controls (t>2.349, P<0.05), and the coefficient of variation increased (t>1.974, P<0.05), except those of elbow extension. Conclusion The force measure and the coefficient of variation can reflect the force control in shoulder and elbow motion in stroke patients.

Key words: stroke, hemiplegia, shoulder, elbow, isometric contraction, force control

中图分类号:

R743.3

赵晨钰, 毕胜, 卢茜. 脑卒中偏瘫患者肩肘关节在等长性收缩运动中的力量控制[J]. 《中国康复理论与实践》, 2017, 23(1): 81-84.

ZHAO Chen-yu, BI Sheng, LU Xi. Force Control of Elbow and Shoulder during Isometric Contraction in Hemiparetic Stroke Patients[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2017, 23(1): 81-84.

参考文献

[1] Kang N, Cauraugh JH. Force control in chronic stroke [J]. Neurosci Biobehav Rev, 2015, 52: 38-48.
[2] Patten C, Kothari D, Whitney J, et al. Reliability and responsiveness of elbow trajectory tracking in chronic poststroke hemiparesis [J]. J Rehabil Res Dev, 2003, 40(6): 487-500.
[3] Lodha N, Naik SK, Coombes SA, et al. Force control and degree of motor impairments in chronic stroke [J]. Clin Neurophysiol, 2010, 121(11): 1952-1961.
[4] Dewald JP, Pope PS, Given JD, et al. Abnormal muscle coactivation patterns during isometric torque generation at the elbow and shoulder in hemiparetic subjects [J]. Brain, 1995, 118(2): 495-510.
[5] 何静杰,刘璇. 脑卒中偏瘫侧上肢的评定与康复[J]. 中国康复理论与实践, 2004, 10(9): 571-572.
[6] 洪跃镇,隋建锋,季林红,等. 偏瘫手臂静力力量测量仪器的设计研究[J]. 中国康复医学杂志, 2015, 30(12): 1253-1256.
[7] Yao J, Chen A, Carmona C, et al. Cortical overlap of joint representations contributes to the loss of independent joint control following stroke [J]. Neuroimage, 2009, 45(2): 490-499.
[8] Lukács M. Electrophysiological signs of changes in motor units after ischaemic stroke [J]. Clin Neurophysiol, 2005, 116(7): 1566-1570.
[9] Landgren S, Phillips CG, Porter R. Cortical fields of origin of the monosynaptic pyramidal pathways to some alpha motoneurones of the baboon's hand and forearm [J]. J Physiol, 1962, 161: 112-125.
[10] Phillips CG, Porter R. The pyramidal projection to motoneurones of some muscle groups of the baboon's forelimb [J]. Prog Brain Res, 1964, 12: 222-245.
[11] Brouwer B, Ashby P. Corticospinal projections to upper and lower limb spinal motoneurons in man [J]. Electroencephalogr Clin Neurophysiol, 1990, 76(6): 509-519.
[12] Colebatch JG, Rothwell JC, Day BL, et al. Cortical outflow to proximal arm muscles in man [J]. Brain, 1990, 113(6): 1843-1856.
[13] Freund HJ, Hummelsheim H. Premotor cortex in man: evidence for innervation of proximal limb muscles [J]. Exp Brain Res, 1984, 53(2): 479-482.
[14] Bourbonnais D, Vanden Noven S, Carey KM, et al. Abnormal spatial patterns of elbow muscle activation in hemiparetic human subjects [J]. Brain, 1989, 112(1): 85-102.
[15] Naik SK, Patten C, Lodha N, et al. Force control deficits in chronic stroke: grip formation and release phases [J]. Exp Brain Res, 2011, 211(1): 1-15.
[16] Hu X, Newell KM. Adaptation to bimanual asymmetric weights in isometric force coordination [J]. Neurosci Lett, 2011, 490(2): 121-125.
[17] Lindberg PG, Roche N, Robertson J, et al. Affected and unaffected quantitative aspects of grip force control in hemiparetic patients after stroke [J]. Brain Res, 2012, 1452: 96-107.
[18] Bertrand AM, Mercier C, Shun PL, et al. Effects of weakness on symmetrical bilateral grip force exertion in subjects with hemiparesis [J]. J Neurophysiol, 2004, 91(4): 1579-1585.
[19] Ye Y, Ma L, Yan T, et al. Kinetic measurements of hand motor impairments after mild to moderate stroke using grip control tasks [J]. J Neuroeng Rehabil, 2014, 11: 84.
[20] Kang N, Cauraugh JH. Bimanual force variability and chronic stroke: asymmetrical hand control [J]. PLoS One, 2014, 9(7): e101817.
[21] Vaillancourt DE, Newell KM. Changing complexity in human behavior and physiology through aging and disease [J]. Neurobiol Aging, 2002, 23(1): 1-11.
[22] Latash ML, Anson JG. Synergies in health and disease: relations to adaptive changes in motor coordination [J]. Phys Ther, 2006, 86(8): 1151-1160.
[23] Ward NS. Functional reorganization of the cerebral motor system after stroke [J]. Curr Opin Neurol, 2004, 17(6): 725-730.
[24] Hu X, Loncharich M, Newell KM. Visual information interacts with neuromuscular factors in the coordination of bimanual isometric force [J]. Exp Brain Res, 2011, 209(1): 129-138.
[25] Westerveld AJ, Schouten AC, Veltink PH, et al. Control of thumb force using surface functional electrical stimulation and muscle load sharing [J]. J Neuroeng Rehabil, 2013, 10: 104.

脑卒中偏瘫患者肩肘关节在等长性收缩运动中的力量控制

Force Control of Elbow and Shoulder during Isometric Contraction in Hemiparetic Stroke Patients

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

Metrics

本文评价

推荐阅读 0

[1]	罗丽华, 王雨生, 李剑锋, 董继革. 术后早期综合康复对儿童青少年肱骨髁上骨折伴尺神经损伤的效果[J]. 《中国康复理论与实践》, 2024, 30(1): 105-110.
[2]	林娜, 高菡璐, 卢惠苹, 陈燕清, 郑军凡, 陈述荣. 虚拟现实技术对脑卒中上肢功能影响的弥散张量成像研究[J]. 《中国康复理论与实践》, 2024, 30(1): 61-67.
[3]	王昊懿, 史亚伟, 鲁俊, 许光旭. 主观垂直感知障碍对脑卒中患者功能影响的回顾性研究[J]. 《中国康复理论与实践》, 2024, 30(1): 68-73.
[4]	陈珺雯, 陈谦, 陈程, 李淑月, 刘玲玲, 吴存书, 龚翔, 鲁俊, 许光旭. 改良八段锦身体活动对脑卒中患者心肺功能、运动功能和日常生活活动能力的效果[J]. 《中国康复理论与实践》, 2024, 30(1): 74-80.
[5]	胡永林, 马颖, 窦超, 陆安民, 江小鸽, 宋新建, 肖玉华. 肩部控制训练联合神经松动术对脑卒中偏瘫患者肩痛及上肢功能的效果[J]. 《中国康复理论与实践》, 2024, 30(1): 81-86.
[6]	王贺, 韩靓, 阚梦凡, 于少泓. 电刺激治疗脑卒中后肩手综合征有效性的系统评价与Meta分析[J]. 《中国康复理论与实践》, 2023, 29(9): 1048-1056.
[7]	胡晓诗, 张琦, 岳青, 梁艳华, 李晓松, 冯啊美, 张燕庆. 矫形弹力绷带对痉挛性偏瘫脑性瘫痪患儿步态对称性和步行能力的效果[J]. 《中国康复理论与实践》, 2023, 29(9): 1083-1089.
[8]	孙藤方, 任梦婷, 杨琳, 王耀霆, 王红雨, 闫兴洲. 高压氧治疗联合重复外周磁刺激干预脑卒中患者踝运动功能和平衡能力的效果[J]. 《中国康复理论与实践》, 2023, 29(8): 875-881.
[9]	王亚楠, 刘西花. 脑卒中偏瘫患者主观和客观平衡功能测量的相关性及预测效能[J]. 《中国康复理论与实践》, 2023, 29(8): 890-895.
[10]	王海云, 王寅, 周信杰, 何爱群. 基于“中枢-外周-中枢”理论的经颅直流电刺激结合针刺干预脑卒中患者中枢及上肢功能的效果[J]. 《中国康复理论与实践》, 2023, 29(8): 919-925.
[11]	陈怡婷, 王倩, 崔慎红, 李映彩, 张思鈺, 魏衍旭, 任慧, 冷军, 陈斌. 双侧序贯重复经颅磁刺激干预脑卒中患者上肢运动功能的效果[J]. 《中国康复理论与实践》, 2023, 29(8): 926-932.
[12]	李振亚, 孙洁, 郭鹏飞, 王光明. 脑卒中患者口期和咽期吞咽功能改变与误吸的相关性：基于电视透视吞咽检查[J]. 《中国康复理论与实践》, 2023, 29(8): 933-939.
[13]	华玲, 张一楠, 郑玉, 孙俏仪, 房辉, 宋达. 手控节律音乐治疗对脑卒中后单侧空间忽略的效果[J]. 《中国康复理论与实践》, 2023, 29(7): 833-838.
[14]	蒋孝翠, 刘臻, 苏清伦, 赵秦, 夏晓昧, 陆飞. 间歇性Theta节律经颅磁刺激对脑卒中后非流利性失语的影响[J]. 《中国康复理论与实践》, 2023, 29(7): 839-843.
[15]	许苗苗, 李楠, 应颖, 杨凯翔, 杨婧瑞, 李杰, 邱彦群. 重复外周磁刺激对左右颈7神经交叉移位术后脑卒中患者上肢运动功能的效果[J]. 《中国康复理论与实践》, 2023, 29(6): 686-690.