目的明确骶管注射疗法的作用机制及炎症反应在腰椎间盘突出症发病过程中的作用.方法随机选取24例腰椎间盘突出症患者于骶管注药前后行腰骶棘肌肌电图检查.检测静息自发电位(SP)、运动单位动作电位平均时限(MUP)及最大用力收缩动作电位的波形(MFCP).结果治疗前后双侧正相电位比较有显著差异(P<0.05);双侧MUP值治疗前与治疗后和正常值比较有显著差异(P<0.05);双侧治疗后值和正常值比较无显著差异(0.05).治疗前后MTCP无显著差异(P>0.05)结论经骶管注射后,患者症状减轻,肌电图检查结果趋向正常.

Objective:To determine whether isokinetic eccentric training can improve the strength of the hemiparetic knee extension,gait speed,to evaluate its effect on spasticity in long term stroke survivors and to its side effect on musclar damage. Method: Sixteen subjects with spastic hemiparesis trained three sessions per week for 4 weeks with a Kin Com isokinetic dynamomter. The effects were evaluated from the following tests before and after the training period. The averaged resistance torque of affected knee extensors at 30°/s, 60°/s,120°/s were collected. The average concentric and eccentric torques of the affected knee extensor together with surface electromyography at constant velocities of 30°/s,60°/s,120°/s. The self selected walking speed was measured. The average concentric and eccentric torques of the affected knee extenor and the self selected walking speed were also recorded at 3 weeks after training cessation.Result: After training,the affected knee extensor strength had significantly incresed in both eccentric and concentric actions( P 0 05), while tone remined consistent( P 0 05).The averaged agonist EMG activity had significantly increased( P 0 05) but the restraint of the antagonistic muscles had not increased( P 0.05). The walking speed had significantly increased( P 0 05).At follow up, the improvement of affected knee extensor strength was a slight decline but the improvement of walking speed was continued. At 72 hours after the first time of exercise, the blood levels of C reactive protein and creative kinase had not hingher compared with their normal values. Conclusion:The short term isokinetic eccentric knee extensor training was able to significantly improve chronic stroke survivors′ strength and gait speed without concomitant increases in tone.

Objective:To determine the feasibility of quanitative spasticity after a stroke by measuring the resistance to passive movement using the isokinetic dynamometric techinque.Method:Twelve subjects with spastic hemiparesis participated in the study according to the modified Ashworth scale1.Kin Com isokinetic dynamometer was used to measure the resistance torques of knee extensors at 60°/s、30°/s and 90°/s.Average resistance torque(ART)date were collected from five repetitions on two separate occasions. And the slopes of the linear regression curve of torque velocity data (SLOPE) were caculated.Gait speed was measured as subjects walked 10.0 meters at their most comfortable speed.Result:Pearson product moment correlation coefficients were high (0 80～0 95) for both involved and uninvolved knee for ART at each angular velocities. Meaningful differents were found between the ARTs and the SLOPEs of the involve versus the uninvolved knee. Speraman correlation coefficients were moderate (0 49～0 67) for ARTs and SLOPE of the involved knee. The correlation between SLOPE and gait speed was moderate (r=0 51).Conclusion:Isokinetic dynamometric technique to quantify spasticity is a reliable and valid method of spasticity assessment. Average resistance torques and measurement of SLOPE in the torque velocity curve are sensitive indexes. Author′s address Dept. of Rehabitation,the General Hospital of PLA,Beijing,100853

目的：颈椎间盘突出症为临床常见病，为准确定位依断，我们采用由单一脊神经后支支配的颈棘间肌等颈部深层肌群肌电图检查法，对颈椎间盘突出症患者进行定位诊断。方法：对３４ 例经临床和影像学检查确认为颈椎间盘突出的患者，进行颈部深层肌肌电图测定。结果：与临床及影像学诊断的符合率为９７ ％ 。颈部深层肌异常电位３３ 例，其中失神经电位２８ 例，阳性率８ ２３ ％ 。 Ｃ５ ～６ 椎间盘突出为好发部位，其肌电图异常电位发生率也最高。结论：异常电位的出现与临床症状的轻重有紧密的关系，失神经电位与手／ 臂／ 肩麻木的符合率为８２３ ％ ； 异常电活动与颈、肩、背痛的符合率为９７ ％ ， 且随着电活动的减少，患者疼痛也相应减轻。说明这是一项定量的、无损伤性的定位诊断检查法。