Bourelle Sophie, Berge Benoît, Gautheron Vincent, Cottalorda Jérôme
Service de Chirurgie Pédiatrique, Chu de Saint-Etienne, Hôpital NORD, Saint-Etienne cedex, France.
J Pediatr Orthop B. 2010 May;19(3):211-20. doi: 10.1097/BPB.0b013e32832e957a.
Assessment of treatments in children with cerebral palsy has been well developed, especially in the gait laboratory. However, the prerequisite for walking is adequate postural control. We hypothesize that a treatment of an equinus deformity should improve postural control. Balance control was assessed by static posturography on the Balance Master. Nine diplegic children, six girls and three boys, participated in the study. Assessment was conducted before and after treatment of the equinus deformity. Two static tests (Weight Bearing Squat and the modified Clinical Test for Sensory Interaction on Balance), and two dynamic balance tests (Limits of Stability and Rhythmic Weight Shift) were performed on the Balance Master. After treatment, mean weight-bearing asymmetry measured by the Weight Bearing Squat was significantly improved at 30 degrees of knee flexion. In the modified Clinical Test for Sensory Interaction on Balance, there was a significant improvement in two conditions (eyes closed on foam surface and the composite score). The Limits of Stability was very difficult to perform for almost all the children. In the Rhythmic Weight Shift, mean directional control improved significantly in three conditions (left/right weight shift at 1 s of transition, front/back weight shift at 2 s of transition and the composite score of the front/back direction). The Balance Master offers the opportunity for an objective and easy assessment of postural control in children with cerebral palsy.
对脑瘫患儿治疗方法的评估已经得到了很好的发展，尤其是在步态实验室。然而，行走的前提是要有足够的姿势控制能力。我们假设，治疗马蹄足畸形应该能改善姿势控制。通过在平衡测试仪上进行静态姿势描记法来评估平衡控制能力。九名双侧瘫患儿（六名女孩和三名男孩）参与了这项研究。在治疗马蹄足畸形前后进行评估。在平衡测试仪上进行了两项静态测试（负重深蹲和改良的平衡感觉交互临床测试）以及两项动态平衡测试（稳定极限测试和节律性体重转移测试）。治疗后，通过负重深蹲测量的平均负重不对称性在膝关节屈曲30度时显著改善。在改良的平衡感觉交互临床测试中，在两种情况下（在泡沫表面闭眼以及综合评分）有显著改善。几乎所有患儿都很难完成稳定极限测试。在节律性体重转移测试中，在三种情况下（过渡1秒时的左右体重转移、过渡2秒时的前后体重转移以及前后方向的综合评分）平均方向控制有显著改善。平衡测试仪为客观、简便地评估脑瘫患儿的姿势控制提供了机会。
