Schwartz Michael H, Viehweger Elke, Stout Jean, Novacheck Tom F, Gage James R
Gillette Children's Specialty Healthcare, St. Paul, Minnesota 55101, USA.
J Pediatr Orthop. 2004 Jan-Feb;24(1):45-53.
A retrospective study was used to evaluate the outcome of treatment of 135 ambulatory children with cerebral palsy. Diplegic subjects were selected from the existing database at the Gillette Children's Specialty Healthcare Motion Analysis Laboratory. All subjects had undergone gait analysis before and after intervention, which included orthopaedic surgery, selective dorsal rhizotomy, or both treatments. Outcome was based on gait pathology, gait efficiency, functional walking ability, and higher-level functional skills. Gait pathology was assessed using 16 clinically relevant kinematic parameters. Gait efficiency was assessed with steady-state oxygen consumption. Walking ability and higher-level functional skills were based on patient report surveys. Improvements were seen in all outcome measures. A significant majority of subjects (79%) improved on a predominance of outcome measures; only 7% of subjects worsened. Within the restrictions of this study design, the results indicate that surgical intervention, guided by preoperative gait analysis, is effective and safe for children with cerebral palsy.
一项回顾性研究用于评估135名门诊脑瘫儿童的治疗结果。双瘫受试者从吉列儿童专科医疗运动分析实验室的现有数据库中选取。所有受试者在干预前后均接受了步态分析，干预措施包括骨科手术、选择性背根切断术或两种治疗方法。结果基于步态病理学、步态效率、功能性步行能力和更高水平的功能技能。使用16个临床相关运动学参数评估步态病理学。通过稳态耗氧量评估步态效率。步行能力和更高水平的功能技能基于患者报告调查。所有结果指标均有改善。绝大多数受试者（79%）在大多数结果指标上有所改善；只有7%的受试者病情恶化。在本研究设计的限制范围内，结果表明，在术前步态分析指导下的手术干预对脑瘫儿童是有效且安全的。
