Bober Tadeusz, Dziuba Alicja, Kobel-Buys Krystyna, Kulig Kornelia
University School of Physical Education, Biomechanics Laboratory, Wroclaw, Poland.
Acta Bioeng Biomech. 2008;10(1):37-42.
The action of three functional rockers, namely the heel, ankle and forefoot rocker, assist the progression of the leg over the supporting foot. The purpose of this case series was to analyze the occurrence of foot rockers during gait in three children with cerebral palsy (CP) who had undergone the tendo-Achilles lengthening (TAL), procedure followed by a clinic- or home-based intervention and in one child with CP without history of surgery. Self-selected gait was video-recorded in a laboratory during six testing sessions at half-year intervals rendering a 3 year period of observation. One child had pre- and post-surgical gait data and the other two had post surgical data only. Sagittal plane knee angular velocity, as well as foot to ground positions, and foot rocker occurrence were analyzed. In a child with history of CP, and without history of surgery, mean angular velocities of the 1st, 2nd and 3rd foot rocker were 3.7, 0.57 and 6.67 rad/s, respectively, and the step length and cadence were normal. In children who underwent TAL the 1st and 2nd rocker was absent, as the initial contact of the foot with the ground was either with foot-flat or forefoot. The mean velocity of the 3rd rocker in children who underwent TAL was lower by approximately 50-80% than that of the nonsurgical case. Furthermore, the characteristic pattern of the knee joint to foot-floor position during gait was not observed in these cases. Foot rocker analysis identified children with abnormal gait characteristics. Following surgery these gait characteristics remained abnormal.
三种功能性摇椅动作，即足跟、踝关节和前足摇椅动作，有助于腿部在支撑脚上向前移动。本病例系列的目的是分析三名接受跟腱延长术（TAL）的脑瘫（CP）儿童在步态中足部摇椅动作的发生情况，这些儿童术后接受了门诊或家庭干预，还有一名无手术史的CP儿童。在实验室中，以半年为间隔进行了六次测试，对自选步态进行了视频记录，观察期为3年。一名儿童有术前和术后的步态数据，另外两名儿童只有术后数据。分析了矢状面膝关节角速度、足部与地面的位置以及足部摇椅动作的发生情况。在一名有CP病史但无手术史的儿童中，第一、第二和第三足部摇椅的平均角速度分别为3.7、0.57和6.67弧度/秒，步长和步频正常。在接受TAL手术的儿童中，第一和第二摇椅动作不存在，因为足部与地面的初始接触要么是平足着地，要么是前足着地。接受TAL手术的儿童中第三摇椅的平均速度比未手术的儿童低约50%-80%。此外，在这些病例中未观察到步态期间膝关节与地面位置的特征模式。足部摇椅分析识别出步态特征异常的儿童。手术后这些步态特征仍然异常。
