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首页> 外文期刊>Neurorehabilitation and neural repair >Reduced Voluntary Activation During Brief and Sustained Contractions of a Hand Muscle in Secondary-Progressive Multiple Sclerosis Patients
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Reduced Voluntary Activation During Brief and Sustained Contractions of a Hand Muscle in Secondary-Progressive Multiple Sclerosis Patients

机译：继发进行性多发性硬化症患者手部肌肉短暂和持续收缩过程中的自愿激活减少

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Background. Secondary-progressive multiple sclerosis (SPMS) patients have structural cortical damage resulting in increased compensatory cortical activity during (submaximal) performance. However, functional effects of changed cortical output are difficult to measure. The interpolated-twitch technique allows for measurement of voluntary activation (VA) necessary for force production. This study aimed to determine VA, force, and muscle fatigue during brief and sustained contractions in SPMS patients. Because fatigue effects are not confined to the motor system, we additionally examined fatiguing effects on cognitive performance. Methods. Twenty-five SPMS and 25 sex-, age-, and education-matched participants performed brief (5 seconds) and sustained (2 minutes) maximal index finger abductions. To evaluate VA, double-pulse twitches were evoked before, during, and after contractions. Additionally, data were compared with data obtained in relapsing-remitting multiple sclerosis (RRMS) patients. Subjects also performed choice-reaction time tasks before and after the sustained contraction. Results. During brief contractions, VA (85% vs 94%, P = .004) and force (25 N vs 32 N, P = .011) were lower for SPMS patients than controls. During sustained contractions, VA (P = .001) was also lower, resulting in greater force decline (73% vs 63%, P < .001) and reduced peripheral fatigue (19% vs 50%, P < .001). Comparisons with RRMS resulted in lower VA, greater force decline, and greater estimated central fatigue in SPMS. SPMS patients were slower (P < .001) and made more errors (P < .001) than controls, but neither group reduced their performance after the sustained contraction. Conclusion. SPMS patients had lower VA than RRMS patients and controls. The importance of voluntary activation for muscle force and fatigability warrants targeted rehabilitation strategies.
机译：背景。继发进行性多发性硬化症（SPMS）患者的皮层结构受损，导致（次最大）表现期间代偿性皮层活动增加。然而，皮质输出改变的功能影响很难测量。内插抽动技术可以测量产生力所必需的主动激活（VA）。这项研究旨在确定SPMS患者短暂和持续收缩过程中的VA，力量和肌肉疲劳。由于疲劳影响不仅限于运动系统，因此我们另外研究了疲劳对认知能力的影响。方法。 25名SPMS和25名性别，年龄和教育程度相匹配的参与者进行了短暂的（5秒）和持续的（2分钟）的最大食指外展。为了评估VA，在收缩之前，期间和之后诱发双脉冲抽搐。此外，将数据与复发缓解型多发性硬化症（RRMS）患者获得的数据进行比较。在持续收缩前后，受试者还执行选择反应时间任务。结果。在短暂收缩期间，SPMS患者的VA（85％vs 94％，P = .004）和力量（25 N vs 32 N，P = .011）低于对照组。在持续收缩期间，VA（P = .001）也较低，从而导致更大的力量下降（73％vs 63％，P <.001）和减轻的外周疲劳（19％vs 50％，P <.001）。与RRMS的比较导致SPMS中的VA降低，力下降更大，中心疲劳估计更高。 SPMS患者比对照组慢（P <.001），并且犯了更多错误（P <.001），但两组均未出现持续收缩后的表现降低。结论。 SPMS患者的VA低于RRMS患者和对照组。自愿激活对于肌肉力量和易疲劳性的重要性需要有针对性的康复策略。

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