脑卒中偏瘫患者患侧和健侧上肢关节的 等速肌力特征研究.

Objective：To analyze the characteristics of muscle strength around the shoulder and wrist joints of the ipsilateral and contralateral upper limbs of stroke patient. Method：A total of 30 stroke patients with hemiplegia were selected as the observation group, and 30 healthy people of the same age were selected as the control group. In the observation group, all patients underwent bilateral shoulder and wrist isokinetic muscle strength tests (60°/s and 120°/s), grip strength and pinch strengthtest, and upper extremity motor evoked potential (MEP) test by transcranial magnetic stimulation. In the healthy control group, the limbs corresponding to the affected side of the observation group were detected. The correlation analysis was performed between the results of isokinetic muscle strength test on the affected side of the observation group and FMA-UE and upper limb MEP. Result：①Isokinetic muscle strength test：At 60°/s and 120°/s, compared with those of the healthy side and the control group, the peak torque (PT), total work (TW) and average power (AP) of shoulder flexor and extensor muscles, shoulder adductors and abductors and wrist flexor and extensor muscles of the affected side in the observation group were significantly decreased (P<0.05). At 60°/s, compared with those of the healthy people, the PT, TW and AP values of the shoulder flexor and extensor muscles, shoulder adductors and abductors and wrist flexors and extensors in the observation group showed a downward trend. And the PT, TW and AP values of the shoulder adductors decreased with statistical significance(P<0.05). At 120°/s, compared with the healthy people, the PT, TW and AP values of the shoulder flexor and abductor muscles on the healthy side of the observation group all showed a downward trend. The PT and AP of the shoulder extensor muscle, and the PT, TW and AP of the shoulder adductor muscle decreased with statistical significance (P<0.05)；the PT and AP value of the wrist flexor muscle and the PT value of the wrist extensor muscle showed a downward trend. ② Grip strength and pinch strength test：The grip strength, lateral pinch strength and fingertip pinch strength of the affected side of the observation group were significantly lower than those of the unaffected side and the healthy people (P<0.05). The grip strength, lateral pinch strength and fingertip pinch strength of the unaffected side of the observation group were significantly lower than those of the healthy people (P< 0.05). ③Neuroelectrophysiological test：The MEP latency and central motor conduction time (CMCT) of the affected upper limb were significantly longer than those of the healthy side and healthy person (P<0.05)； There was no significant difference in the MEP latency and CMCT between the healthy upper limb and the healthy people (P>0.05). ④Correlation analysis：In the observation group, isokinetic muscle strength of the muscle groups around the shoulder and wrist joints of the affected side were significantly positively correlated with FMA-UE(P<0.05), while had no correlation with MEP latency and CMCT of the affected upper limb. Conclusion：Stroke patients with hemiplegia have bilateral muscle strength decline, and after Brunnstrom Ⅲ, muscle strength may not be related to motor nerve conduction velocity. Future research and clinical treatment should expand the focus beyond the affected side and advocate bilateral assessment and training. [ABSTRACT FROM AUTHOR]