Evaluation of Muscle Strength in Patients with Spinal Muscular Atrophy

脊髓肌肉萎縮症患者的肌力評估

王慧儀(Hui-Yi Wang) ； 楊奕馨(Yi-Hsin Yang) ； 鐘育志(Yuh-Jyh Jong)

《The Kaohsiung Journal of Medical Sciences》 18卷5期 (2002/05) Pp. 241-247

https://doi.org/10.6452/KJMS.200205.0241

摘要

本研究的目的為評估脊髓肌肉萎縮症(簡稱SMA)患者的肌力以取得肌力分數，並分析身體各部位平均肌力分數的差異情況。研究對象為25名第II型SMA(平均年齡為13.7±7.0歲)及15名第Ⅲ型SMA患者(平均年齡為13.7±8.2歲)。以徒手肌力測量法測量每一患者共71個肌群，以取得個別肌群肌力分數，及特定部位：包括位於四肢關節上的肌群、上肢的屈曲肌和伸展肌，及下肢的屈曲肌和伸展肌等之平均肌力分數。使用多變數變異量分析法及成對t檢定以各自分析第II型及第Ⅲ型SMA患者之肌力資料。測量結果顯示在兩類型SMA患者中，軀幹及髖關節處的個別肌群肌力分數較低，而手肘屈曲肌、手腕屈曲肌及伸展肌、手指屈曲肌及橫隔膜肌則呈現較高的肌力分數。在第II型SMA患者中，位於左側肩胛關節、手肘及手腕關節處之肌群所得之平均股力分數比在右側該處肌群之平均分數顯著地較低。結果中同時顯示在兩類型SMA患者中，上肢屈曲肌之平均肌力分數顯著地高於上肢伸展肌之平均分數。下肢屈曲肌平均分數顯著地高於下肢伸展肌則只見於第II型SMA患者中。從本研究中能了解第II型及第III型SMA患者之肌肉力量及身體各部位肌力的差異情況。

並列摘要

The first aim of this study was to evaluate the muscular strength in order to document the strength scores for patients with spinal muscular atrophy (SMA). The second aim was to analyze the differences in average strength score among the musculatures at various body parts. Twenty-five patients with type II SMA (mean age of 13.7 ± 7.0 years) and 15 patients with type III SMA (mean age of 13.7 ± 8.2 years) were enrolled to undergo a muscle strength evaluation using the method of manual muscle testing. For each patient, the strength of 71 muscle groups were graded using a numerical ordinal scale to obtain individual muscle group scores, average scores of the arms, legs, the musculatures around the limbs' joints, the arm flexors and extensors, and leg flexors and extensors. The data were analyzed using a statistic model of multivariate analysis of variance and paired t-test. All data were administrated respectively for type II and type III SMA. The results showed that in both types of patients, the trunk muscles and the musculatures around the hips possessed lower strength scores, whereas elbow flexors, wrist flexors and extensors, finger flexors, and diaphragms exhibited relatively higher strength scores. In type II SMA the average scores of the musculatures of the left side arms was lower than those of the right side at the joints of scapulas, elbows and wrists. Our data also showed the arm flexor scores were higher than the arm extensor scores in both types, whereas significant higher score of the leg flexor in comparison to the leg extensor was only found in the patients with type II SMA. The profiles of muscle strength and strength differences over various body parts in the patients with type II SMA as well as the type III SMA were obtained from this study.

並列關鍵字

spinal muscular atrophy ； muscle strength