Rinehart Nicole J, Tonge Bruce J, Iansek Robert, McGinley Jenny, Brereton Avril V, Enticott Peter G, Bradshaw John L
Centre for Developmental Psychiatry, School of Psychology, Psychiatry, and Psychological Medicine, Monash University, Clayton, Australia.
Dev Med Child Neurol. 2006 Oct;48(10):819-24. doi: 10.1017/S0012162206001769.
We investigated gait in newly diagnosed children with autism. From our previous study with 6- to 14-year-olds, we hypothesized that motor symptoms indicative of basal ganglia and cerebellar dysfunction would appear across the developmental trajectory of autism. Two groups were recruited: children with autism (eight males, three females; mean age 5 y 10 mo [SD 9 mo]; range 4 y 4 mo-6 y 9 mo) and a comparison group of typically developing children (eight males, three females; mean age 5 y 9 mo [SD 1 y 1 mo]; range 4 y 3 mo-7 y 2 mo). The GAITRite Walkway was used to gather data from average gait and intra-walk measurements. Experienced physiotherapists analyzed gait qualitatively. Groups were matched according to age, height, weight, and IQ; although not statistically significant, IQ was lower in the group with autism. Spatiotemporal gait data for children with autism were compatible with findings from patients with cerebellar ataxia: specifically, greater difficulty walking along a straight line, and the coexistence of variable stride length and duration. Children with autism were also less coordinated and rated as more variable and inconsistent (i.e. reduced smoothness) relative to the comparison group. Postural abnormalities in the head and trunk suggest additional involvement of the fronto-striatal basal ganglia region. Abnormal gait features are stable across key developmental periods and are, therefore, promising for use in clinical screening for autism.
我们对新诊断的自闭症儿童的步态进行了研究。根据我们之前对6至14岁儿童的研究，我们假设，表明基底神经节和小脑功能障碍的运动症状会在自闭症的整个发育轨迹中出现。我们招募了两组儿童：自闭症儿童（8名男性，3名女性；平均年龄5岁10个月[标准差9个月]；范围4岁4个月至6岁9个月）和一组发育正常的对照儿童（8名男性，3名女性；平均年龄5岁9个月[标准差1岁1个月]；范围4岁3个月至7岁2个月）。使用GAITRite步道收集平均步态和步行过程中的测量数据。经验丰富的物理治疗师对步态进行了定性分析。两组儿童在年龄、身高、体重和智商方面进行了匹配；虽然差异无统计学意义，但自闭症组儿童的智商较低。自闭症儿童的时空步态数据与小脑共济失调患者的研究结果一致：具体表现为，沿直线行走时困难更大，步幅长度和步幅持续时间存在变化。与对照组相比，自闭症儿童的协调性也较差，且被评定为变化更大、更不一致（即流畅性降低）。头部和躯干的姿势异常表明额纹状体基底神经节区域也受到了影响。异常步态特征在关键发育阶段是稳定的，因此有望用于自闭症临床筛查。
