背景與目的: 脊髓神經迴路與肌肉特性會在脊髓損傷投產生動態性的改變，進而產生瘦孽。這些變化並 不是受悔初期即發生，而是逐漸改變而來。然而，過去研究對脊髓神經肌肉的適應的暸解則相當有限，因此研 究中樞神經損傷役之神經迴路與肌肉特性之時程變化對於發展相對應之彼健方式顯得格外重要。方法. 本研究 收取20 個健康受試者與31 名受傷時間不同的脊髓損傷患者，評估健康人與脊髓損傷患者之H 反射活化後抑制、 交替抑制、運動神經元興奮性與肌肉疲乏指數之適應程度。使用線性迴歸分析與單因子變異數分析，瞭解脊髓 損傷後神經肌肉適應性隨時間之改變，以及與健康人之差異。結果: 本研究觀察到活化後抑制隨著脊髓損傷受 傷時間增加而逐漸減少的現象。交替抑制隨受傷時間的增長而出現逐漸消失的現象。運動神經元興奮性在脊髓 損傷往會逐漸的上升， 疲勞指數則在受傷後疲勞指數會快速的下降。結論: 本研究發現在脊髓損傷後，神經迴 路與肌肉特性會隨著受傷時間而逐漸適應改變，此結果將可被當為在受傷後不同階段處理脊髓損傷患者之瘦學 症狀的一個重要指標。( 物理治療20 1 6;4 1 (3) :2 11-222)

Background and purpose: After spinal corcl injury (SCI), the spinal ci rcuits and muscle charactcristics show dramatic ch anges in parallel to the developmem of spastic ity. l hese changes do not occur instan taneously, but instead undergo a series of adaptations with time post injury. H owever, the understanding of spinal neuromuscular aclaptation following spinal cord injury is quite limited. 'l11erefore, to d evelop the novel rehabili t ation approachcs, it is particularly important to unclerstancl the time-course changes of spinal c irc uits and muscle characteristics fo llowing spinal cord injury. Methods: We recruited 20 hcalthy su bjccts and 3 1 inclividuals with SCI for the testing of adaptation in post activatio n depression of H ref1exes (PAD), reciprocal inhibition (RI), motor neuron excita bility, and fatigue index. Regression analysis and O ne way a nalysis of variancc were used to analyze the time-course adaptations and the differences between healthy and SCI subjects. Results: Wc found chat the PAD and RI in paciencs with spinal cord injury were gradually reduced with time. The motor neuron excitability revealed gradually increased and fatigue index sharply decreased after spinal cord injury, respectively. Conclusian: In this study} the progressive adaptations of spinal circuit and muscle characteristics were observed after spinal cord injury* Tliese parameters can be as imporrant indicators for the evaluation and management of spasticity in patients with different stages oF spinal cord injury. (FJPT 2016;41(3):211-222)