Kumhar Ghanshyam D, Dua Tarun, Gupta Piyush
Department of Pediatrics, University College of Medical Sciences and GTB Hospital, Delhi, India.
Eur J Paediatr Neurol. 2002;6(6):321-5. doi: 10.1016/s1090-3798(02)90620-3.
The objective of the study was to characterize the plantar response at various ages in infancy in Indian children. The subjects were 1281 apparently healthy children born at term and without any history suggestive of neurological disease, enrolled between the ages of 1 and 12 months. The plantar response was elicited in both feet by thumbnail drag method and graded as flexor, extensor and equivocal. The percentage of extensor, flexor and equivocal responses was compared between right and left foot and the average of these two responses was compared between the age categories [1-3 months (n=389), 3.1-6 months (n=332), 6.1-9 months (n=354) and 9.1-12 months (n=206)]. Frequency (%) of various combinations of bilateral responses was also calculated for different age categories. Results showed that the extensor plantar response was the predominant response till 6 months of age. Bilateral extensor response was seen in 79.4%, 67.8%, 32.5% and 31.1% in the four age categories respectively; bilateral flexor response in the corresponding age groups was 0.3%, 5.1%, 26.6% and 39.3% respectively. The percentage of asymmetrical responses was 20.7%, 25.3%, 40.3%, and 28.7% in different age categories. We concluded that normal plantar response is predominantly extensor in early infancy; the transition to flexor response starts occurring after 6 months of age. A fairly high number of infants continue to have an extensor response even after 6 months; and the transition may be advanced in one foot leading to asymmetrical plantar response.
该研究的目的是描述印度儿童婴儿期不同年龄段的足底反应特征。研究对象为1281名足月出生且无任何神经疾病史的健康儿童，年龄在1至12个月之间。采用拇指甲划擦法引出双足底反应，并分为屈肌反应、伸肌反应和可疑反应进行分级。比较左右足底伸肌、屈肌和可疑反应的百分比，并比较不同年龄组（1 - 3个月，n = 389；3.1 - 6个月，n = 332；6.1 - 9个月，n = 354；9.1 - 12个月，n = 206）这两种反应的平均值。还计算了不同年龄组双侧反应各种组合的频率（%）。结果显示，直到6个月龄，足底伸肌反应是主要反应。四个年龄组中双侧伸肌反应分别为79.4%、67.8%、32.5%和31.1%；相应年龄组双侧屈肌反应分别为0.3%、5.1%、26.6%和39.3%。不同年龄组不对称反应的百分比分别为20.7%、25.3%、40.3%和28.7%。我们得出结论，正常足底反应在婴儿早期主要为伸肌反应；6个月龄后开始向屈肌反应转变。即使在6个月后，仍有相当数量的婴儿继续表现为伸肌反应；而且这种转变可能在一只脚中提前出现，导致足底反应不对称。
