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应用等速被动测试方法对偏瘫膝伸痉挛肌群的量化评定

更新时间:2012-10-11 13:24:43  
徐军 瓮长水 高怀民 王素平 刘冰 于增志

摘要 目的:建立等速被动测试偏瘫下肢痉挛肌群量化评定的方法和量化指标,并研究其信度、效度及与步速的相关性。方法:受试者为改良Ashworth分>1分的12例偏瘫患者;测试仪器为Kin-Com等速装置,测试角度为60°/s、30°/s、90°/s;并进行了测试后重复测试。此外尚进行了10m步速测量。结果:平均被动阻力力距测试后重复测试的Pearson相关系数为0.80~0.95;内容效度t检验被动阻力力矩和阻力力距-速度线性回归曲线上升斜率2项痉挛量化指标受累侧与非受累侧之间有显著差异(P<0.05);实证效度检验2项指标与改良Ashworth分呈正相关,Speraman等级相关系数为0.49~0.67。阻力力距-速度线性回归曲线上升斜率与步速之间存在中度相关关系(r=0.51)。结论:等速被动测试中平均阻力力距和阻力力距-速度线性回归曲线上升斜率作为痉挛量化指标具有较好的重测信度、内容效度和实证效度,其中回归曲线上升斜率在反映痉挛程度及应用上可能意义更大些。
关键词 痉挛;量化评定;等速装置;偏瘫

An quantifying assessment for spasticity after stroke with isokinetic dynamometer

XU Jun,WENG Changshui,GAO Huaimin,et al
Chinese Journal of Rehabilitation Medicine,1999,14(6):253~256

Abstract Objective:To determine the feasibility of quanitative spasticity after a stroke by measuring the resistance to passive movement using the isokinetic dynamometric techinque.Method:Twelve subjects with spastic hemiparesis participated in the study according to the modified Ashworth scale>1.Kin-Com isokinetic dynamometer was used to measure the resistance torques of knee extensors at 60°/s、30°/s and 90°/s.Average resistance torque(ART)date were collected from five repetitions on two separate occasions. And the slopes of the linear regression curve of torque-velocity data (SLOPE) were caculated.Gait speed was measured as subjects walked 10.0 meters at their most comfortable speed.Result:Pearson product-moment correlation coefficients were high (0.80~0.95) for both involved and uninvolved knee for ART at each angular velocities. Meaningful differents were found between the ARTs and the SLOPEs of the involve versus the uninvolved knee. Speraman correlation coefficients were moderate (0.49~0.67) for ARTs and SLOPE of the involved knee. The correlation between SLOPE and gait speed was moderate (r=0.51).Conclusion:Isokinetic dynamometric technique to quantify spasticity is a reliable and valid method of spasticity as

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