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目的 比较健康老人与脑卒中急性期患者的踝背伸和踝跖屈肌群的收缩功能 ,为脑卒中急性期康复提供客观依据。方法 2组对象参加研究 ,对照组为 11位健康老人 ,年龄 62 .3± 5 .7岁 ;脑卒中组为12位初发患者 ,年龄 66.6± 8.3岁。测试时下肢固定在支架上 ,压力传感器放在足底 ,肌电图的表面电极放在胫骨前肌和腓肠肌的体表上 ,记录踝背伸或踝跖屈时最大等长收缩、胫骨前肌和腓肠肌的肌电活动 ,并计算力矩和积分肌电图的变化。结果 健康老人左、右侧踝背伸和踝跖屈肌群收缩各参数之间的差异无显著性 ,脑卒中组患侧与健侧比较差异有显著性 (P <0 .0 5 ) ;协方差分析 (年龄作为协变量 )发现 ,脑卒中组的患侧与对照组比较 ,踝背伸和踝跖屈力矩、积分肌电图以及协同收缩率的差异有高度显著性 (P <0 .0 1) ,脑卒中组健侧与对照组的踝背伸协同收缩率差异有显著性 (P <0 .0 5 )。结论 脑卒中急性期患者踝背伸和踝跖屈肌群收缩功能明显降低 ,增强这些肌群的收缩功能 ,特别是增强主动肌的收缩 ,抑制拮抗肌的协同收缩应作为脑卒中急性期康复的目标
Objective To compare the contractile function of ankle dorsiflexion and ankle plantar flexion in healthy elderly and acute stroke patients and to provide an objective basis for the rehabilitation of acute stroke in healthy people. Method 2 subjects participated in the study, the control group of 11 healthy elderly, aged 62.3 ± 5. .7 years; stroke group of 12 patients with initial onset, age 66.6 ± 8.3 years. Test the lower extremity fixed on the stent, the pressure sensor on the soles of the feet, EMG surface electrode on the tibialis anterior muscle and gastrocnemius body surface record ankle dorsiflexion or ankle plantar flexion maximum isometric contraction, tibialis anterior muscle And gastrocnemius muscle EMG activity, and calculate the torque and integral electromyography changes. Results There were no significant differences in the parameters of contractility between the ankle dorsiflexion and ankle plantar flexion in healthy elderly. There was significant difference between contralateral and contralateral sides in stroke group (P <0.05). Covariance Analysis (age as a covariate) found that the ipsilateral ankle dorsiflexion and plantar flexion moment, integral electromyography, and systolic contraction were significantly higher in the ipsilateral stroke group than in the control group (P <0.01) There was significant difference in systolic and contractile ankle dorsiflexion between contralateral stroke group and control group (P <0.05). Conclusion The systolic function of ankle dorsiflexion and ankle plantar flexor muscles in patients with acute stroke is significantly reduced, and the contractile function of these muscles is enhanced, especially the contraction of active muscles and the synergistic contraction of antagonistic muscles should be the targets of acute stroke rehabilitation