等速肌力检测在辨别伪肢体瘫中的应用

Application of Isokinetic Muscle Testing in Identification of the Faked Paralysis

目的探讨等速肌力检测在法医学鉴定中辨别伪肢体瘫的应用价值,为建立规范、统一的法医学肌力评价方法提供科学依据。方法选取骨折或神经损伤者57例(损伤组)和伪装者128例(伪装组),应用等速肌力测试系统对损伤组两侧膝关节与伪装组膝关节进行检测,对双侧膝关节屈、伸肌的峰力矩(peak torque,PT)、峰力矩角度(peak torque angle,PTA)进行比较,归纳两组膝关节的力矩-时间图特征。结果损伤组膝关节屈、伸肌的双侧PT的比较差异有统计学意义(P<0.05),PTA的比较差异无统计学意义(P>0.05);伪装组膝关节屈、伸肌的双侧PT、PTA的比较差异均有统计学意义(P<0.05)。损伤组两侧膝关节力矩-时间图主要为单峰前置型,伪装组膝关节力矩-时间图主要为多峰型。结论在法医学鉴定中,等速肌力检测在辨别伪肢体瘫方面可以通过力矩-时间图的相关特点进行评价。

Objective To study the application of isokinetic muscle testing in identification of the faked paralysis to provide scientific data for establishing a standard systemof muscle strength in forensic medicine identification. Methods Fifty-seven patients with bone fracture or nerve damage as damaged group and 128 normal subjects pretended paralysis as faked paralyzed group were included in this study. Isokinetic muscle testing was performed on bilateral knees of all subjects in the two groups. The peak torque （PT） and peak torque angle （PTA ） were compared between both sides in each group. The fea-tures of torque-time graph of two groups were classified. Results In the damaged group, the differences of PTbetween two sides of flexors and extensors were statistically significant （P〈0.05）, while the dif-ferences of PTA were not statistically significant （P〉0.05）. In faked paralyzed group, the differences of PTand PTA between two sides of flexors and extensors were both statistically significant （P〈0.05）. The torque-time graph of damaged knee presented mostly as single lead peak, while torque-time graph of the faked paralyzed knee presented mostly as multiple peaks. Conclusion The feature of torque-time graph could be useful to identify the faked paralyzed extremities in forensic authentication.