C_5和C_6脊髓损伤患者与正常人在伸肘活动中上肢的角位移及角速度比较

The angular displacement and angular velocity of the upper limb during elbow extension activities in spinal cord injury patients and normal individuals

目的研究C5和C6脊髓损伤(SCI)患者在伸肘活动中上肢的运动策略。方法采用Peak Motus运动解析系统对15例C5和C6水平SCI患者和15例正常人在抓取杯子、触摸开关、驱动轮椅和利用上肢负重4项伸肘动作中肩、肘、腕关节的角位移及角速度进行分析。结果与正常人相比,SCI患者在抓取杯子、触摸开关、驱动轮椅动作中的运动时间明显延长(P<0．05);在触摸开关和驱动轮椅动作中的角速度明显减慢(P<0．05);在前3项伸肘活动中,SCI患者主要依靠增加或减小肩关节的角位移来完成运动任务,而在利用上肢负重的动作中,则通过改变肩、肘关节在矢状面上的运动方向来代偿其功能缺陷。结论 C5和C6 水平SCI患者采用与正常人不同的运动模式和策略来完成伸肘活动。

Objective To study upper limb motor strategies during elbow extension activities in C5-6 spinal cord injury （SCI） patients and compare them with the strategies of normal individuals. Methods A Peak Motus motion analysis system was used to measure the angular displacement and the angular velocity of the shoulder, elbow and wrist of fifteen C5-6 SCI patients and fifteen healthy subjects during four elbow extension activities including grasping a cup, reaching for a light switch, wheelchair ambulation and upper limb weight-bearing. Results Compared with normal individuals, the movement time of the SCI patients was significantly longer during the grasping, reaching and wheelchair ambulation activities. The angular velocity was significantly slower during reaching for a light switch and wheelchair ambulation. The patients with spinal cord injury performed the motor tasks primarily relying on increasing or decreasing the angular displacement of the shoulder during the former three elbow extension activities. They compensated for any functional deficiency by changing the movement direction of the shoulder and elbow in sagittal projection during upper limb weight-bearing activities. Conclusion C5-6 SCI patients utilize different motor patterns and strategies from healthy subjects to complete elbow extension activities.