等速运动测试仪量化评定痉挛的研究

Isoknetic Dynamometric Technique for the Quantitative Assessment of Spasticity

痉挛是上运动神经元损伤性疾患的常见症状。正确评定和处理痉挛有重要的临床意义。但是由于痉挛是肌肉在病理状态下的一种神经生理表现，不易直接测量，尤其是量化评定的问题成为康复医学研究中的一个难题，越来越受到人们的关注。本研究目的：寻找一种痉挛量化评定的新方法。方法：利用等速运动测试仪ＣｙｂｅｘⅡ结合评定痉挛常用的摆动试验进行痉挛的量化评定研究。本研究对观察组３４例痉挛患者，对照１组９例驰缓性麻痹患者，对照２组１０例正常人下肢肌张力进行了评定。结果：记录到了各种不同的摆动曲线，并找到５个有代表性的特征性参数：Ａ１（第一摆膝关节屈曲角度）、Ｒ１、（放松指数）、Ｒ２、（幅度比）、Ｔ（摆动时间）、Ｆ（摆动次数）。经统计学检验观察组与对照组间有显著差异。实验结果信度、效度很高。

Spasticity is a common problem in upper motor neuron lesions.Assessment of spasticity is extremely valuable in quantifying the effects of a therapeutic intervention.But it is,in other hand,a difficult and challenging problem.Objective:The present study was undertaken to determine the feasibility of quantifying spasticity by the pendulum test using the isokinetic dynamometric technique.We suggest that this machine can be used to perform pendulum test to quantify spasticity.Method:We studied the lower limb muscle tone in 34 spastic subjects,and in 9 flaccid paralysis control subjects,and 10 normal control subjects.Result:Typical pendulun test goniograms of each group were obtained and 5 parameters are extracted from the goniograms to evaluate the degree of spasticity. They are:Al(the flexion angle of the first drop)、R1(relaxation index)、R2(amplitude ratio)、T(time of swings)、F(frequency of swings).The correlation coefficients are calculated to determine the reliability of the parameters(>0.90 for three consecutive test;>0.80 for different days).The validity is determined by t test(p<0.01).Conclusion:The method of using isokinetic dynamometric technique combining pendulum test to quantify spasticity is a reliable,valid,accurate and convenient method of assessing spasticity.