Wichers Marc, Hilberink Sander, Roebroeck Marij E, van Nieuwenhuizen Onno, Stam Henk J
Deptartment of Rehabilitation Medicine, Erasmus MC-University Medical Centre Rotterdam, PO Box 2040, NL-3000 CA Rotterdam, The Netherlands.
J Rehabil Med. 2009 Apr;41(5):367-74. doi: 10.2340/16501977-0339.
To determine the prevalence of motor impairments and activity limitations and their inter-relationships in Dutch children with spastic cerebral palsy.
In a population-based survey 119 children, age range 6-19 years, with spastic cerebral palsy were examined. Anthropometry, muscle tone, abnormal posture, joint range of motion, major orthopaedic impairments and gross motor functioning and manual ability were assessed or classified, in addition to limitations in mobility and self-care activities. Spearman's correlation coefficients, bivariate post hoc analyses and univariate and multivariate logistic regression analyses were used.
Children with spastic cerebral palsy had a lower body height and weight compared with typically developing peers. Forty percent had no range of motion deficits. Hip dislocations were rarely encountered. Motor impairments were associated with gross motor functioning and manual ability levels. Close to sixty-five percent walked independently. Children with diplegia and tetraplegia differed in activity limitations. Motor impairments and limitations in mobility and self-care activities were only modestly related in multivariate analyses.
Distribution of cerebral palsy-related characteristics is consistent with that found in representative studies of other countries. The distinction between diplegia and tetraplegia is relevant from an activity point of view. The child's activity limitations are not a mirror of the motor impairments, which suggests multifactorial influences. An activity-oriented rehabilitation approach goes beyond treating specific impairments.
确定荷兰痉挛型脑瘫儿童运动障碍和活动受限的患病率及其相互关系。
在一项基于人群的调查中，对119名年龄在6至19岁之间的痉挛型脑瘫儿童进行了检查。除了评估活动能力和自我护理活动的受限情况外，还对人体测量学、肌张力、异常姿势、关节活动范围、主要骨科损伤、粗大运动功能和手部能力进行了评估或分类。使用了斯皮尔曼相关系数、双变量事后分析以及单变量和多变量逻辑回归分析。
与正常发育的同龄人相比，痉挛型脑瘫儿童的身高和体重较低。40%的儿童没有活动范围缺陷。髋关节脱位很少见。运动障碍与粗大运动功能和手部能力水平相关。近65%的儿童能够独立行走。双瘫和四肢瘫儿童在活动受限方面存在差异。在多变量分析中，运动障碍与活动能力和自我护理活动的受限仅存在适度关联。
脑瘫相关特征的分布与其他国家代表性研究中的结果一致。从活动角度来看，双瘫和四肢瘫的区分具有相关性。儿童的活动受限并非运动障碍的反映，这表明存在多因素影响。以活动为导向的康复方法超越了对特定损伤的治疗。
