Ross Sandy A, Engsberg Jack R
Department of Physical Therapy, Maryville University, St. Louis, MO 63141-7299, USA.
Arch Phys Med Rehabil. 2007 Sep;88(9):1114-20. doi: 10.1016/j.apmr.2007.06.011.
To determine the relationships between spasticity, strength, and the functional measures of gait and gross motor function in persons with spastic diplegia cerebral palsy (CP).
Retrospective, cross-sectional study.
Hospital clinic.
Ninety-seven participants (49 boys, 48 girls; mean age+/-standard deviation, 9.11+/-4.8 y) with spastic diplegia CP were tested once.
Not applicable.
A KinCom dynamometer was used to objectively measure spasticity (ankle plantarflexors, knee flexors, hip adductors) and maximum strength (ankle dorsiflexors and plantarflexors, knee flexors and extensors, hip abductors and adductors). A gait analysis was conducted to evaluate linear variables (gait speed, stride length, cadence) and kinematic variables (ankle dorsiflexion, foot progression, knee and hip flexion, pelvic tilt at initial contact and ankle dorsiflexion, knee and hip flexion, pelvic tilt, trunk rotation range of motion) during gait. Gross motor function was measured using the Gross Motor Function Measure (GMFM-66) and separately, the GMFM walking, running & jumping dimension. Multiple linear regression analysis was used to determine the relationships between spasticity, strength, gait, and the GMFM (P<.05).
Spasticity did not account for a substantial amount of explained variance in gait and gross motor function (up to 8% for the GMFM walking, running & jumping dimension). Moderate to high correlations existed between strength and gait linear data and function, accounting for up to 69% of the explained variance (strength and GMFM-66, r2=.69).
For this cohort of participants with spastic diplegia CP who ambulated with or without an assistive device, strength was highly related to function and explained far more of the variance than spasticity. The results may not be generalized to those with more severe forms of CP.
确定痉挛型双侧瘫脑瘫（CP）患者的痉挛、力量与步态及粗大运动功能的功能测量指标之间的关系。
回顾性横断面研究。
医院诊所。
97名痉挛型双侧瘫CP患者（49名男孩，48名女孩；平均年龄±标准差，9.11±4.8岁）接受了一次测试。
不适用。
使用KinCom测力计客观测量痉挛（踝跖屈肌、膝屈肌、髋内收肌）和最大力量（踝背屈肌和跖屈肌、膝屈肌和伸肌、髋外展肌和内收肌）。进行步态分析以评估步态期间的线性变量（步速、步长、步频）和运动学变量（踝背屈、足前进、膝和髋屈曲、初始接触时的骨盆倾斜以及踝背屈、膝和髋屈曲、骨盆倾斜、躯干旋转运动范围）。使用粗大运动功能测量量表（GMFM - 66）测量粗大运动功能，并单独测量GMFM行走、跑步和跳跃维度。采用多元线性回归分析确定痉挛、力量、步态和GMFM之间的关系（P<0.05）。
痉挛在步态和粗大运动功能中所占的可解释方差比例不大（GMFM行走、跑步和跳跃维度最高为8%）。力量与步态线性数据和功能之间存在中度至高度相关性，占可解释方差的比例高达69%（力量与GMFM - 66，r2 = 0.69）。
对于这组使用或不使用辅助装置行走的痉挛型双侧瘫CP患者，力量与功能高度相关，且比痉挛解释的方差更多。这些结果可能不适用于更严重形式的CP患者。
