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首页> 外文期刊>Brain injury: BI >Evaluation of extensibility, passive torque and stretch reflex responses in triceps surae muscles following serial casting to correct spastic equinovarus deformity.
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Evaluation of extensibility, passive torque and stretch reflex responses in triceps surae muscles following serial casting to correct spastic equinovarus deformity.

机译：连续石膏矫正痉挛性等位畸形后，评估肱三头肌肱三头肌的可扩展性，被动扭矩和拉伸反射反应。

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摘要

Primary objective: Spastic equinovarus deformity of the ankle in adults with acquired brain injury can severely limit the achievement of rehabilitation goals. This study examined changes in triceps surae muscle extensibility, passive resistive torque and soleus stretch reflex responses in 10 adult brain injured subjects undergoing serial casting to correct ankle equinovarus deformity. Method: Goniometric measurement of maximal passive dorsiflexion was used to evaluate extensibility of the triceps surae muscles. Computer controlled ankle dynamometry and surface electromyography were used to identify passive resistive torque and soleus stretch reflex onset angle in response to stretches at two velocities. Results: The mean casting period was 5 weeks. Casting was discontinued in one subject due to failure to achieve measurable gain in ankle range over three consecutive cast changes. Median improvements in maximal ankle dorsiflexion, with the knee flexed or extended, of 30 degrees and 15 degrees, respectively, were achieved in the remaining nine subjects (p < 0.0001). The median passive ankle range in response to a displacing torque of 10 Nm increased 4.3 degrees over the intervention period (p < 0.0001). Consistent soleus reflex activity in response to passive stretches at 25 degrees.s(-1) was elicited in only four subjects. A trend for the stretch reflex onset to move further into the available range was demonstrated in these subjects. Conclusion: In the present study, serial casting contributed to significant change in triceps surae extensibility and passive resistive torque, corresponding with improved maximal passive ankle dorsiflexion range and an increase in the angle achieved with a displacing torque of 10 N.m. Increased stretch reflex threshold was observed in some subjects. The use of pre-determined outcome criteria and careful measurement of responses to this intervention were important to prevent premature discontinuation of casting when gains were slower than expected.
机译：主要目的：患有获得性脑损伤的成年人的踝关节痉挛性畸形畸形会严重限制康复目标的实现。这项研究检查了10名成年脑损伤受试者的三头肌腓肠肌可扩展性，被动抵抗扭矩和比目鱼肌反射反射的变化，这些受试者正在接受连续铸造以纠正踝关节等角畸形。方法：采用测角法测量最大被动背屈，以评估肱三头肌的伸展性。使用计算机控制的脚踝测力计和表面肌电图来识别被动阻力和比目鱼肌拉伸反射起搏角，以响应两个速度下的拉伸。结果：平均铸造期为5周。由于在三个连续的铸模更换中未能达到可测量的踝关节增幅，因此停止在一个受试者中进行铸模。在其余九名受试者中，随着屈曲或伸展膝盖，最大踝背屈的中位改善分别达到30度和15度（p <0.0001）。在干预期间，响应于10 Nm的位移扭矩，被动踝关节中位范围增加了4.3度（p <0.0001）。仅在四个对象中引起响应于25度s.-1的被动拉伸的比目鱼自发反射活动一致。在这些受试者中证明了伸展反射发作进一步向可用范围发展的趋势。结论：在本研究中，连续铸造有助于肱三头肌可扩展性和被动抵抗扭矩的显着变化，这与改善最大被动踝背屈范围和位移扭矩为10 N.m时获得的角度增加有关。在某些受试者中观察到拉伸反射阈值升高。使用预先确定的结果标准并仔细测量对此干预措施的响应，对于防止在获益慢于预期的情况下防止铸件过早停止很重要。

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