Schoenmakers Marja A G C, de Groot Janke F, Gorter Jan Willem, Hillaert Jobke L M, Helders Paul J M, Takken Tim
Departments of Paediatric Physiotherapy and Exercise Physiology, Wilhelmina Children's Hospital, University Medical Centre, Utrecht, The Netherlands.
Disabil Rehabil. 2009;31(4):259-66. doi: 10.1080/09638280801923235.
This cross-sectional study investigates deficits and associations in muscle strength, 6-minute walking distance (6MWD), aerobic capacity (VO(2peak)), and physical activity (PA) in independent ambulatory children with lumbosacral spina bifida.
Twenty-tree children participated (13 boys, 10 girls). Mean age (SD): 10.4 (+/-3.1) years. Muscle strength (manual muscle testing and hand-held dynamometry), 6MWD, VO(2peak) (maximal exercise test on a treadmill), and PA (quantity and energy expenditure [EE]), were measured and compared with aged-matched reference values.
Strength of upper and lower extremity muscles, and VO(2peak) were significantly lower compared to reference values. Mean Z-scores ranged from -1.2 to -2.9 for muscle strength, and from -1.7 to -4.1 for VO2peak. EE ranged from 73 - 84% of predicted EE. 6MWD was significantly associated with muscle strength of hip abductors and foot dorsal flexors. VO(2peak) was significantly associated with strength of hip flexors, hip abductors, knee extensors, foot dorsal flexors, and calf muscles.
These children have significantly reduced muscle strength, 6MWD, VO(2peak) and lower levels of PA, compared to reference values. VO(2peak) and 6MWD were significantly associated with muscle strength, especially with hip abductor and ankle muscles. Therefore, even in independent ambulating children training on endurance and muscle strength seems indicated.
本横断面研究调查了独立行走的腰骶部脊柱裂患儿在肌肉力量、6分钟步行距离(6MWD)、有氧能力(VO₂峰值)和身体活动(PA)方面的缺陷及相关性。
23名儿童参与研究(13名男孩,10名女孩)。平均年龄(标准差):10.4(±3.1)岁。测量了肌肉力量(徒手肌力测试和手持测力计)、6MWD、VO₂峰值(跑步机上的最大运动测试)和PA(数量和能量消耗[EE]),并与年龄匹配的参考值进行比较。
与参考值相比,上肢和下肢肌肉力量以及VO₂峰值显著降低。肌肉力量的平均Z值范围为-1.2至-2.9,VO₂峰值的平均Z值范围为-1.7至-4.1。EE范围为预测EE的73%-84%。6MWD与髋外展肌和足背屈肌的肌肉力量显著相关。VO₂峰值与髋屈肌、髋外展肌、膝伸肌、足背屈肌和小腿肌肉的力量显著相关。
与参考值相比,这些儿童的肌肉力量、6MWD、VO₂峰值显著降低,PA水平也较低。VO₂峰值和6MWD与肌肉力量显著相关,尤其是与髋外展肌和踝关节肌肉。因此,即使是独立行走的儿童,似乎也需要进行耐力和肌肉力量训练。