等速测试指标与改良Ashworth量表用于踝痉挛评定的相关性研究

摘要

Objective To study the correlation between isokinetic parameters and modified Ashworth Scale (MAS) in ankle spasticity as-sessment. Methods 18 stroke patients (spasticity group) and 16 healthy subjects (control group) in our hospitals from August 2014 to March 2015 were included. MAS was used to assess the ankle muscular tension. The ankle passive movement of both groups was measured with BIODEX isokinetic motor assessment system under 10 °/s, 60 °/s, 120 °/s, 180 °/s, 240 °/s. The peak torque (PT), peak torque/body weight (PT/BW), average torque (AT), and slopes of the linear regression curve of torque-velocity (SLOPE) were recorded. The correlation of the isokinetic paramenters and the MAS were tested with Spearman correlation analysis. Results The PT, PT/BW and AT were higher in the spasticity group than in the control group (P<0.05). And they increased as the angular velocity increased, and slowed after 120 °/s. The corre-lation coefficient of MAS and PT, PT/BW, AT, SLOPE were from 0.3043 to 0.7632 (P<0.01). Conclusion The isokinetic parameters were speed-dependent and closely related to MAS. 120 °/s was of the highest sensitivity, and the SLOPE under this anglular velocity was highly correlated with MAS.%目的：研究等速被动测试指标与改良Ashworth量表(MAS)评定的相关性。方法2014年8月~2015年3月，本院接收康复治疗慢性脑卒中患者18例作为痉挛组，16名健康对照者作为对照组。MAS评定痉挛组踝关节肌张力，BIODEX等速运动测试系统评定两组踝关节被动运动，角速度分别为10°/s、60°/s、120°/s、180°/s、240°/s。测试峰力矩(PT)、峰力矩体重比(PT/BW)、平均力矩(AT)、峰力矩-角速度线性斜率(SLOPE)。运用Spearman法对上述两组结果进行相关分析。结果痉挛组不同角速度PT、PT/BW、AT均大于对照组(P<0.05)，等速指标随角速度增大而增大，120°/s后上升缓慢。痉挛组4个等速指标与MAS相关系数为0.3043~0.7632(P<0.01)，SLOPE的数值最大。结论等速指标与MAS具有相关性，符合痉挛中速度依赖的定义。120°/s敏感性最高，SLOPE与MAS相关性最显著。