在中风后的患者中,隔膜和cleidomastoid肌肉活动与增加的启发性压力负荷增加
Fang Liu1,2, Alice Y M Jones3, Raymond C C Tsang4
1Department of Physiotherapy, School of Nursing and Health Sciences, Hong Kong Metropolitan University, Hong Kong, China.
Scientific reports
|February 18, 2025
概括
在中风后的患者中,腹膜和骨肌 (SCM) 肌肉在增加的吸气压力时会以不同的方式收缩. 较高的负载主要涉及SCM肌肉,而不是隔膜,这表明需要重新评估鼓舞肌肉训练强度.
科学领域:
- 神经学 神经学
- 呼吸系统生理学 呼吸系统生理学
- 康复医学 康复医学 康复医学
背景情况:
- 卒中幸存者经常经历呼吸道肌肉功能受损.
- 腹膜和骨肌 (SCM) 肌肉对于呼吸至关重要,但它们在中风后的协调还没有完全理解.
- 启发性肌肉训练 (IMT) 在康复中使用,但最佳参数需要澄清.
研究的目的:
- 在中风患者中,研究膜和SCM肌肉在不同启发性压力负荷下同时收缩的模式.
- 为了确定不同的吸气负荷如何影响半截面肌肉和SCM肌肉活动,在半截面和未受影响的侧面.
- 为临床启发性肌肉训练计划提供最佳强度的信息.
主要方法:
- 三十六名中风患者在增加的吸入压力负载 (30-80%的最大吸入压力,MIP) 进行了呼吸练习.
- 表面电肌图 (sEMG) 记录了SCM肌肉活动,而超声波测量了隔膜厚度.
- 隔膜加厚分数 (DTf) 被计算出来以评估隔膜收缩大小.
主要成果:
- 半截肢侧的隔膜厚度减少了.
- 隔膜收缩 (DTf) 增加,负载高达50%的MIP,然后下降.
- 随着负载增加,SCM肌肉的招募增加,达到80%的MIP,并且在半侧更高.
结论:
- 灵感负荷超过50%的MIP主要由SCM肌肉活动支持,额外的隔膜贡献有限.
- 目前使用高强度 (>50%MIP) 的IMT协议可能无法在中风患者中最佳地刺激腹膜.
- 根据这些发现,应重新考虑临床IMT强度建议,以最大限度地提高治疗效益.
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