School of Sport Science, Exercise and Health, The University of Western Australia, Perth, Australia.
Gait Posture. 2011 Feb;33(2):214-9. doi: 10.1016/j.gaitpost.2010.11.008. Epub 2010 Dec 4.
To determine changes in upper limb movement substructures that denote fluency of movement in children with cerebral palsy (CP) following lycra(®) splint wear. Secondarily, to explore the efficacy of lycra(®) splints for those with spastic and dystonic hypertonia.
Randomised clinical trial whereby participants were randomised to parallel groups with waiting list control.
Sixteen children (mean age 11.5 years SD=2.2) with hypertonic upper limb involvement (13 hemiplegia, 4 quadriplegia) were recruited. Children were randomly allocated either to a control group or to wear the lycra(®) splint for a period of three months. Three-dimensional (3D) upper limb kinematics was used to assess four functional tasks at baseline, on initial lycra(®) splint application, three months after lycra(®) splint wear, and immediately after splint removal. Movement substructures of the motion of the wrist joint center were analysed.
A significant difference was observed between baseline and three months of lycra(®) splint wear in the movement substructures; movement time, percentage of time and distance in primary movement, jerk index, normalised jerk and percentage of jerk in primary and secondary movements. The magnitude of changes in normalised jerk and the percentage of jerk in the primary movement from baseline to three months was greatest in children with dystonic hypertonia.
The results indicate that lycra(®) arm splinting induced significant changes in movement substructures and motor performance in children with CP. This research demonstrates that fluency of movement can be quantified and is amenable to change with intervention.
确定脑瘫（CP）儿童在穿戴莱卡（®）夹板后上肢运动亚结构的变化，这些变化表示运动流畅性。其次，探索莱卡（®）夹板对痉挛性和张力障碍性高张力的疗效。
参与者被随机分配到平行组的随机对照临床试验，其中有等待名单对照。
招募了 16 名上肢高张力受累的儿童（平均年龄 11.5 岁，标准差=2.2）（13 例偏瘫，4 例四肢瘫）。儿童被随机分配到对照组或穿戴莱卡（®）夹板三个月。使用三维（3D）上肢运动学评估四个功能任务，基线、初始莱卡（®）夹板应用时、穿戴莱卡（®）夹板三个月后和立即拆除夹板后。分析腕关节中心运动的运动亚结构。
在穿戴莱卡（®）夹板的三个月内，基线和运动亚结构之间观察到显著差异；运动时间、主运动中的时间百分比和距离、急动指数、主运动和次运动中的归一化急动和急动百分比。从基线到三个月，正常化急动和主运动中急动百分比的变化幅度在张力障碍性高张力儿童中最大。
结果表明，莱卡（®）手臂夹板在 CP 儿童的运动亚结构和运动表现方面引起了显著变化。这项研究表明，运动流畅性可以量化，并且可以通过干预来改变。
