Évaluation isocinétique de la force musculaire de patients atteints de polyradiculonévrite aiguë

Muscle strength recovery in treated Guillain-Barré syndrome: a prospective study for the first 18 months after onset

OBJECTIVE

To assess the recovery in muscle strength and functional capacities in subjects with Guillain-Barré syndrome (GBS) for 18 months after onset.

DESIGN

Six GBS patients were treated and transferred to our rehabilitation center within the first week of recovery.

RESULTS

Isometric and isokinetic strength increased significantly during the first 6 months (P < 0.01). Between 6 and 18 months, muscle strength increased less rapidly (P < 0.05). We showed a significant negative correlation between plateau period duration and knee extensors, elbow flexors muscles strength recovery (rho = -0.82; P = 0.05). At 6 months, manual muscle testing and functional independence motor total scores were close to normal levels. At 18 months, all patients satisfied the criteria for a full recovery. However, they felt difficulties after prolonged exercise.

CONCLUSIONS

Until 18 months of recovery, dynamometric measures still showed significant strength improvement. This underscores the need for a minimal 24 months of clinical follow-up with an individualized rehabilitation management program.

Isokinetic muscle testing for weak patients suffering from neuromuscular disorders: A reliability study

Precise, sensitive muscle strength testing methods are needed to investigate muscle function in patients with neuromuscular disorders (NMD). Here, we describe an isokinetic knee flexor and extensor testing procedure using the Biodex 3's continuous passive motion (CPM) mode. The torque values recorded during passive isokinetic motion were subtracted from the torque values obtained for the same movement with maximal, concentric effort. The aims of the present study were to (i) evaluate the method's reliability in NMD patients presenting mild to severe muscle weakness and (ii) study the relationship between manual muscle testing (MMT) and isokinetic dynamometry. The fifteen participating patients were tested twice; the respective intraclass correlation coefficients (ICCs) for the two sessions ranged from 0.91 to 0.99 for the peak torque, work and power and from 0.50 to 0.90 for the angle at peak torque. The Spearman rho correlation coefficients comparing isokinetic values and MMT values ranged from 0.67 to 0.74 (p<0.01). This reliable, dynamic method appears to be of great value in NMD evaluation when sensitive strength measurement at the knee is required.