陈彦,吴霜,王志涛,等.早期腰段不完全脊髓损伤患者膝关节肌群肌力与步行能力的关系[J].中华物理医学与康复杂志,2021,43(11):987-990
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| 早期腰段不完全脊髓损伤患者膝关节肌群肌力与步行能力的关系 |
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| DOI：10.3760/cma.j.issn.0254-1424.2021.11.006 |
| 中文关键词: 不完全脊髓损伤 肌力 步速 脊髓损伤步行指数 |
| 英文关键词: Spinal cord injury Muscle strength Walking speed Walking Index for Spinal Cord Injury II |
| 基金项目:国家自然科学基金项目（82060419）；贵州省科学技术厅基金项目（黔科合同LG字［2012］037号）；贵州省卫生健康委科学技术基金项目（gzwkj2011-1-103,gzwjkj2019-1-155） |
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| 中文摘要: |
| 目的 研究早期腰段不完全脊髓损伤患者膝关节肌群肌力与步行能力的相关性以及影响其步行能力的因素。 方法 对符合入选标准的早期腰段不完全脊髓损伤患者27例进行双侧股四头肌、腘绳肌徒手肌力评定（MMT）、峰力矩测试（PT）、10 m步行时间测试（10MWT）和脊髓损伤步行指数（WISCI Ⅱ）评定。采用Spearman相关分析方法确定股四头肌MMT、腘绳肌MMT、股四头肌PT和腘绳肌PT与10MWT和WISCI Ⅱ的相关性。采用逐步回归分析法分析10MWT和WISCI Ⅱ的影响因素。 结果 腘绳肌MMT与10MWT呈显著负相关（r=-0.703,P<0.01），与WISCI Ⅱ呈显著正相关（r=0.713,P<0.01）；腘绳肌PT与10MWT呈中等负相关（r=-0.413,P<0.05），与WISCI Ⅱ呈中等正相关（r=0.433,P<0.05）。10MWT与WISCI Ⅱ呈强负相关（r=-0.986,P<0.01）。腘绳肌MMT是影响10MWT和WISCIⅡ的最主要因素（r2分别为0.549和0.536），股四头肌MMT是影响10MWT和WISCIⅡ的的次要因素。腘绳肌和股四头肌的MMT对10MWT和WISCI Ⅱ变化的总贡献率分别为62.5%和64.1%。 结论 早期腰段不完全脊髓损伤患者的膝关节屈肌群的肌力与其10MWT和WISCIⅡ有显著相关性，膝关节屈伸肌群肌力可在一定程度上预测早期腰段不完全脊髓损伤患者的早期步行功能。 |
| 英文摘要: |
| Objective To explore any correlation between knee muscle strength and walking ability after an incomplete lumbar spinal cord injury and the factors influencing walking ability. Methods Twenty-seven persons with an incomplete lumbar spinal cord injury were tested. Their bilateral quadriceps and hamstring muscle strength and peak torque during knee extension and flexion were assessed. They completed the 10m walking time test (10MWT) and each person′s WWISCI II spinal cord injury walking index was evaluated. Spearman correlations among the data were computed and stepwise regression was used to analyze the factors significantly influencing the 10MWT and WISCI II results. Results The average hamstring strength was significantly negatively correlated with the 10MWT times and WISCI II ratings. Hamstring torque also was negatively correlated with the 10MWT times, but positively correlated with the WISCI II ratings. The 10MWT times and WISCI II ratings were significantly inter-correlated. Hamstring strength was the best predictor of 10MWT times (accounting for 63% of the variance) and WISCI II ratings (64%), but quadriceps strength was also a secondary predictor. Conclusions Knee muscle strength is a useful predictor of 10MWT times and WISCI II ratings after incomplete lumbar spinal cord injury. It can predict early walking ability to some extent. |
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