脑卒中后胫骨前肌形态结构与肌力变化的超声评估

关键词：脑卒中  超声  胫骨前肌

Keywords:stroke  ultrasound  tibialis anterior

摘要：

      摘要 目的：应用超声技术测量亚急性期脑卒中患者胫骨前肌静息状态与最大等长收缩状态下肌肉的形态结构参数，探讨肌肉参数的改变与关节角度以及发力功能之间的关系。 方法：选择7例亚急性期脑卒中患者与7名性别年龄相匹配的正常人，应用B型超声测量不同踝关节角度下脑卒中患者健侧、患侧和正常人一侧下肢胫骨前肌的形态结构参数，包括羽状角、肌肉厚度以及肌纤维长度，同时用便携式肌力与关节活动测试仪记录踝背屈肌力及踝关节角度，研究不同关节角度下肌肉参数及其与发力之间的关系。 结果：脑卒中患者患侧胫骨前肌的羽状角和肌肉厚度较健侧减小，并且羽状角和肌纤维长度均与踝关节角度相关。肌肉收缩时患侧三个参数的改变及踝背屈肌力均较健侧以及正常人减小，而健侧和正常人无显著性差异。 结论：脑卒中后患者胫骨前肌的形态结构参数发生了改变，肌肉参数的改变与踝关节角度和发力是相关的，可能导致了运动功能障碍。

Abstract:

      Abstract Objective: To evaluate the architectural changes of tibialis anterior (TA) at rest and during maximum isometric voluntary contraction(MIVC) in subacute stroke survivors, measured by ultrasound and to investigate the correlations of muscle archilectual parameters with the ankle joint position and strength changes. Method: Seven subacute stroke survivors and seven age- and sex-matched healthy subjects were recruited in this study. The muscle architectures parameters of affected side and uneffected side of TA including the pennation angle, thickness, and fascicular length were measured at various ankle positions by ultrasonography. The muscle strength and the ankle angle were recorded by hand-held dynamometer. Result: At the affected side of stroke survivors pennation angle and thickness of TA were less than those at the unaffected side. The measured pennation angles and fascicle lengths were found to be ankle joint angle-dependent at both the affected and unaffected sides. Furthermore, there were smaller changes of the three architectural parameters and smaller muscle strength at the affected side during maximum isometric voluntary contraction compared with those at the unaffected side and healthy subjects. Conclusion: There are considerable changes in the muscle architecture of TA post-stroke, which are ankle joint angle-dependent and related to muscle strength, may contribute directly to impaired motor functions in stroke survivors.