van der Heide Jolanda C, Fock Johanna M, Otten Bert, Stremmelaar Elisabeth, Hadders-Algra Mijna
Department of Neurology, University Hospital Groningen, The Netherlands.
Pediatr Res. 2005 Sep;58(3):586-93. doi: 10.1203/01.pdr.0000176834.47305.26.
The relationships between kinematic characteristics of sitting posture during reaching movements of the dominant arm and 1) the kinematics of the reaching movement itself and 2) functional performance during daily life activities (PEDI) were assessed in 51 sitting preterm children with cerebral palsy (CP). The children were 2-11 y, 33 had spastic hemiplegia (SH) and 18 bilateral CP (Bi-CP). The data were compared with those of 26 typically developing children (TD). Sitting posture before the onset of reaching of children with CP differed from that of TD children: they sat with a more reclined pelvis and a more collapsed trunk. The more reclined pelvic position was associated with a better quality of reaching movements. The different sitting postures of pelvis and trunk were not related to functional performance during daily life activities. Displacement of the head, trunk, and pelvis of the children with CP did not differ from that of the TD children. Nevertheless, in the children with CP a more stable head, a more mobile trunk, and a more stable pelvis were related to better functional performance and/or a better quality of reaching. This suggests that physiotherapeutic guidance of children with CP should focus rather on the latter postural parameters than on the different sitting posture of pelvis and trunk.
在51名患有脑瘫(CP)的坐位早产儿中,评估了优势手臂伸展运动期间坐姿的运动学特征与1)伸展运动本身的运动学以及2)日常生活活动中的功能表现(PEDI)之间的关系。这些儿童年龄在2至11岁之间,33名患有痉挛性偏瘫(SH),18名患有双侧脑瘫(Bi-CP)。将这些数据与26名发育正常的儿童(TD)的数据进行比较。患有CP的儿童在开始伸展运动前的坐姿与TD儿童不同:他们坐着时骨盆更后倾,躯干更塌陷。骨盆后倾程度越大,伸展运动质量越好。骨盆和躯干的不同坐姿与日常生活活动中的功能表现无关。患有CP的儿童头部、躯干和骨盆的位移与TD儿童没有差异。然而,在患有CP的儿童中,头部更稳定、躯干更灵活以及骨盆更稳定与更好的功能表现和/或更好的伸展运动质量相关。这表明对患有CP的儿童进行物理治疗指导时,应更多地关注后者的姿势参数,而不是骨盆和躯干的不同坐姿。