CAJ | 학술논문

目的：探讨等速肌力检测在法医学鉴定中辨别伪肢体瘫的应用价值，为建立规范、统一的法医学肌力评价方法提供科学依据。方法选取骨折或神经损伤者57例（损伤组）和伪装者128例（伪装组），应用等速肌力测试系统对损伤组两侧膝关节与伪装组膝关节进行检测，对双侧膝关节屈、伸肌的峰力矩（peak torque，PT）、峰力矩角度（peak torque angle，PTA）进行比较，归纳两组膝关节的力矩-时间图特征。结果损伤组膝关节屈、伸肌的双侧PT的比较差异有统计学意义（P＜0.05），PTA的比较差异无统计学意义（P＞0.05）；伪装组膝关节屈、伸肌的双侧PT、PTA的比较差异均有统计学意义（P＜0.05）。损伤组两侧膝关节力矩-时间图主要为单峰前置型，伪装组膝关节力矩-时间图主要为多峰型。结论在法医学鉴定中，等速肌力检测在辨别伪肢体瘫方面可以通过力矩-时间图的相关特点进行评价。
목적：탐토등속기력검측재법의학감정중변별위지체탄적응용개치，위건립규범、통일적법의학기력평개방법제공과학의거。방법선취골절혹신경손상자57례（손상조）화위장자128례（위장조），응용등속기력측시계통대손상조량측슬관절여위장조슬관절진행검측，대쌍측슬관절굴、신기적봉력구（peak torque，PT）、봉력구각도（peak torque angle，PTA）진행비교，귀납량조슬관절적력구-시간도특정。결과손상조슬관절굴、신기적쌍측PT적비교차이유통계학의의（P＜0.05），PTA적비교차이무통계학의의（P＞0.05）；위장조슬관절굴、신기적쌍측PT、PTA적비교차이균유통계학의의（P＜0.05）。손상조량측슬관절력구-시간도주요위단봉전치형，위장조슬관절력구-시간도주요위다봉형。결론재법의학감정중，등속기력검측재변별위지체탄방면가이통과력구-시간도적상관특점진행평개。
Objective To study the application of isokinetic muscle testing in identification of the faked paralysis to provide scientific data for establishing a standard systemof muscle strength in forensic medicine identification. Methods Fifty-seven patients with bone fracture or nerve damage as damaged group and 128 normal subjects pretended paralysis as faked paralyzed group were included in this study. Isokinetic muscle testing was performed on bilateral knees of all subjects in the two groups. The peak torque (PT) and peak torque angle (PTA ) were compared between both sides in each group. The fea-tures of torque-time graph of two groups were classified. Results In the damaged group, the differences of PTbetween two sides of flexors and extensors were statistically significant (P<0.05), while the dif-ferences of PTA were not statistically significant (P>0.05). In faked paralyzed group, the differences of PTand PTA between two sides of flexors and extensors were both statistically significant (P<0.05). The torque-time graph of damaged knee presented mostly as single lead peak, while torque-time graph of the faked paralyzed knee presented mostly as multiple peaks. Conclusion The feature of torque-time graph could be useful to identify the faked paralyzed extremities in forensic authentication.