慢性脑血管意外患者脑损害同侧下肢肌力改变的分析

Impaired strength of the ipsilateral lower extremity in patients with chronic hemiplegia

目的:通过对慢性脑血管意外患者脑损害同侧下肢肌力的评定及与健康对照组的比较,确定其是否存在肌力降低以及可能的特点。方法:实验组为14例男性单侧脑血管意外(左侧脑损害10例,右侧脑损害4例)、病程≥6个月,对照组为14例健康可比者。应用Kin-Com等速装置,以60°/s、180°/s角速度测试实验组脑损害同侧下肢、对照组左侧下肢膝伸、膝屈和踝跖屈、背屈向心收缩、离心收缩肌力,以平均峰值力矩为评定指标。结果:所有测试结果均表明实验组脑损害同侧下肢肌力低于健康对照组,其中180°/s膝伸向心收缩、离心收缩肌力、60°/s、180°/s踝跖屈向心收缩、离心收缩肌力、180°/s踝背屈离心收缩肌力显著低于健康对照组(P<0.05)。结论:慢性脑血管意外患者普遍存在脑损害同侧下肢肌力降低的现象,且与损害半球无关。脑损害同侧下肢不应视为“非受累侧”下肢。

Objective:To compare the strength of the ipsilateral lower extremity of chronic patients with that of healthy elderly people to confirm the presence of decreased strength and its feature.Method:The group of stroke patients was composed of14male hemiplegic subjects who had a cerebrovascular accident at least6months earli-er.A group of14healthy controls was used for comparison.The Kin-Com isokinetic dynamometer was used to measure the muscular strength of knee extension and flexion,ankle plantar flexion and dorsal flexion at60°/s and180°/s.Average peak torque data were collected from6repetitions during concentric and eccentric contraction.Result:All measures were decreased in the ipsilateral lower extremity of patients compared with controls.Signifi-cant decrements were seen during concentric and eccentric knee extension at180°/s,concentric and eccentric an-kle plantar flexion at60°/s?180°/s and eccentric ankle dorsal flexion at180°/s( P<0.05).Conclusion:Impaired strength of the ipsilateral lower extremity is common in the chronic unilateral cerebral vascular accident,and re-gardless of hemisphere damaged.The ipsilateral lower extremity to the lesion may be not the so-called'unaffected'lower limb.Author's address Dept.of Rehabilitation Medicine,The General Hospital of PAL,Beijing,100853