Neuromusculoskeletal and Movement-Related Functions
Motor weakness is found in 80% to 90% of all patients after stroke . Hemiparesis with uniform weakness of the hand , foot , shoulder , and hip is the most frequent motor deficit profile , constituting at least two thirds of all cases . Flaccidity may be evident early on ; however , spasticity may develop in the acute phase as well . Limb flaccidity may be associated with retained reflexes ; not infrequently reflexes remain normal or even increase .Although many authors have tried to find differences in frequency , severity , and profile of the hemiparesis in right – and left – sided lesions , the majority of such studies showed no significant differences .
Patients after stroke typically experience changes in muscle tone , contralateral weakness ( although ipsilateral weakness also is sometimes evident ) , and poor endurance .
Left unattended over time , muscle stiffness and learned nonuse are likely to occur . An extensive review of the causes of weakness in hemiplegia appears in the occupational therapy literature . Although further study clearly is needed in this area , this review substantiates the notion that far too much emphasis has been placed on the role of spasticity in producing the inability to activate affected muscles .An increasing body of knowledge points to alterations in the physiology of motor units , particularly regarding changes in firing rates and muscle fiber atrophy , and the contribution of other factors results in mechanical restraint of agonist muscles by their antagonists . Early intervention aimed at avoiding contractures and facilitating activation of the more involved side is crucial even if consensus is lacking on the effective means .
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Neuromusculoskeletal和與運動相關的作用 馬達弱點在80%到90%所有患者中被找到在衝程以後。 與手、腳、肩膀和臀部的一致的弱點的Hemiparesis是最頻繁的馬達缺乏外形，構成所有案件的至少三分之二。 Flaccidity也許在初期是顯然的; 然而，痙攣狀態在深刻階段也許開发。 肢體flaccidity也許同保留的反射联系在一起; 反射不罕見地依然是法線甚至增加。雖然許多作者设法發現在頻率、hemiparesis的嚴肅和外形上的區別在正确的&的; ndash; 並且左& ndash; 支持的損害，這樣的多數不學習显示了出重大區別。 在衝程經驗以後的患者在肌肉紧张、對側弱點(雖然身體的同側的弱點也是有時顯然的)和恶劣的耐力典型地改變。 左未看管隨著時間的推移，肌肉僵硬和博學的不使用可能發生。 弱點的起因的廣泛的回顾在偏癱的出现於作业治疗文學。 雖然进一步研究在這個區域明顯地必要，這回顧證實概念在痙攣狀態的角色重视了在导致無能激活受影響的肌肉。增長的大量的知识在电动机组里生理指向改變，特別關於在生火率和肌纤维萎縮上的变化和其他因素結果的貢獻在收縮筋肌肉機械克制的由他們的反對者。 瞄準的早期的干預避免攣縮和促進更加包含的邊的活化作用是關鍵的，即使公眾輿論在有效的手段缺乏。Source(s): 自己