Objective: The purpose of this study was first to compare the kinematic parame ters of imposed ankle mobilizations measured during Ashworth or isokinetic tests and, second, to better understand why the stretch reflex ...Objective: The purpose of this study was first to compare the kinematic parame ters of imposed ankle mobilizations measured during Ashworth or isokinetic tests and, second, to better understand why the stretch reflex was more or less easil y elicited by one method or the other. Methods: Passive dorsiflexions were appli ed on eight adult patients with plantarflexor spasticity in two conditions: (i) manually, using the Ashworth test where passive dorsiflexions were performed fre ely by seven rehabilitation clinicians, and (ii) instrumentally, using an isokin etic device (Cybex(r) Norm(tm) and a dorsiflexion velocity at 300°/s.Mean value s of initial ankle position, maximal angular velocity(θ′max), maximal angular acceleration (θ″max) and plantarflexorreflex responses obtained with each meth od were compared.Results: During the Ashworth test, all the patients presented r eflex activities in the triceps surae while, during the isokinetic mobilization, only three out of the eight patients tested shown reflex responses. θ′max val ues were significantly higher(P < 0.05) in the manual test (308±80°/s vs 216± 5.5°/s for the isokinetic test). The most marked difference concerned the θ″m ax values (5046±2181°/s2 for the Ashworth test vs 819±18°/s2 for the isokine tic test, P < 0.001). This parameter was significantly correlated with the mean rms-EMG values of the gastrocnemius lateralis (GL) and the soleus (SOL). Conclu sions:This study indicates that passive dorsiflexions imposed during Ashworth an d isokinetic tests largely differ in velocity and acceleration, and the higher d ynamic parameters evaluated during the Ashworth test could mainly explain that t he stretch reflex was more easily elicited during this manual testing. Significa nce:If isokinetic devices offer numerous advantages in the assessment of passive resistance to spastic muscle stretch,they cannot be used to simulate the manual test.展开更多
目的观察火针联合康复训练治疗脑卒中后痉挛性偏瘫(spastc hemiplegia after stroke,SHAS)的效果。方法选取2020年1月到2021年11月阜南县人民医院收治的130例SHAS患者,按随机数字表法分为两组,对照组65例给予常规药物+康复训练,研究组6...目的观察火针联合康复训练治疗脑卒中后痉挛性偏瘫(spastc hemiplegia after stroke,SHAS)的效果。方法选取2020年1月到2021年11月阜南县人民医院收治的130例SHAS患者,按随机数字表法分为两组,对照组65例给予常规药物+康复训练,研究组65例在对照组基础上给予火针。比较疗效、改良Ashworth分级、运动功能、上肢Fugl-Meyer评分(Fugl-Meyer assessment,FMA)、改良巴氏指数(modified Barthel index,MBI)评分。结果研究组总有效率(91.80%)显著高于对照组(78.69%)(P<0.05)。治疗后,研究组与对照组的改良Ashworth分级均优于治疗前(P<0.05),且研究组的改良Ashworth分级明显优于对照组(P<0.05)。治疗后,研究组与对照组的上肢FMA评分、下肢FMA评分、MBI评分均大于治疗前(P<0.05),且研究组的上肢FMA评分、下肢FMA评分、MBI评分增幅较对照组更明显(P<0.05)。结论火针联合康复训练治疗SHAS疗效肯定,能改善肢体痉挛、运动功能及日常生活活动能力。展开更多
文摘Objective: The purpose of this study was first to compare the kinematic parame ters of imposed ankle mobilizations measured during Ashworth or isokinetic tests and, second, to better understand why the stretch reflex was more or less easil y elicited by one method or the other. Methods: Passive dorsiflexions were appli ed on eight adult patients with plantarflexor spasticity in two conditions: (i) manually, using the Ashworth test where passive dorsiflexions were performed fre ely by seven rehabilitation clinicians, and (ii) instrumentally, using an isokin etic device (Cybex(r) Norm(tm) and a dorsiflexion velocity at 300°/s.Mean value s of initial ankle position, maximal angular velocity(θ′max), maximal angular acceleration (θ″max) and plantarflexorreflex responses obtained with each meth od were compared.Results: During the Ashworth test, all the patients presented r eflex activities in the triceps surae while, during the isokinetic mobilization, only three out of the eight patients tested shown reflex responses. θ′max val ues were significantly higher(P < 0.05) in the manual test (308±80°/s vs 216± 5.5°/s for the isokinetic test). The most marked difference concerned the θ″m ax values (5046±2181°/s2 for the Ashworth test vs 819±18°/s2 for the isokine tic test, P < 0.001). This parameter was significantly correlated with the mean rms-EMG values of the gastrocnemius lateralis (GL) and the soleus (SOL). Conclu sions:This study indicates that passive dorsiflexions imposed during Ashworth an d isokinetic tests largely differ in velocity and acceleration, and the higher d ynamic parameters evaluated during the Ashworth test could mainly explain that t he stretch reflex was more easily elicited during this manual testing. Significa nce:If isokinetic devices offer numerous advantages in the assessment of passive resistance to spastic muscle stretch,they cannot be used to simulate the manual test.
