Ballaz Laurent, Plamondon Suzanne, Lemay Martin
Centre de réadaptation Marie-Enfant (CHU Sainte-Justine), Montréal, Québec, Canada.
Clin Biomech (Bristol). 2010 Nov;25(9):944-8. doi: 10.1016/j.clinbiomech.2010.06.011. Epub 2010 Jul 23.
Gait in young people with cerebral palsy is inefficient and there is a lack of relevant indicators for monitoring the problem. In particular, the impact of gait kinematics on gait efficiency is not well documented. The aim of this study is to examine the relationship between gait efficiency, gait kinematics, lower limb muscle strength, and muscular spasticity in adolescents with cerebral palsy.
Ten ambulatory adolescents with spastic cerebral palsy were recruited. The energy expenditure index during gait, gait kinematics, flexion and extension knee isometric muscle strength, and quadriceps spasticity were assessed.
Energy expenditure index (1.5 (0.7) beats/m) was strongly correlated with the ankle and knee flexion/extension ranges of motion (r= -0.82, P<0.01 and r= -0.70, P<0.02, respectively) and also with maximal plantar flexion (r=0.74, P<0.05) during gait. Knee flexion strength was the only strength measurement correlated with energy expenditure index (r= -0.85; P<0.01).
This study suggests that ankle and knee flexion/extension ranges of motion during gait are key kinematics factors in gait efficiency in adolescents with cerebral palsy.
脑瘫青少年的步态效率低下，且缺乏用于监测该问题的相关指标。特别是，步态运动学对步态效率的影响尚无充分记录。本研究的目的是探讨脑瘫青少年的步态效率、步态运动学、下肢肌肉力量和肌肉痉挛之间的关系。
招募了10名患有痉挛性脑瘫的能行走的青少年。评估了步态期间的能量消耗指数、步态运动学、膝关节屈伸等长肌力和股四头肌痉挛情况。
能量消耗指数（1.5（0.7）次/米）与步态期间的踝关节和膝关节屈伸活动范围密切相关（分别为r = -0.82，P < 0.01和r = -0.70，P < 0.02），也与最大跖屈相关（r = 0.74，P < 0.05）。膝关节屈曲力量是唯一与能量消耗指数相关的力量测量指标（r = -0.85；P < 0.01）。
本研究表明，步态期间的踝关节和膝关节屈伸活动范围是脑瘫青少年步态效率的关键运动学因素。
