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痉挛性偏瘫脑瘫患儿上肢位置觉缺陷与距离有关。

Deficits in upper limb position sense of children with Spastic Hemiparetic Cerebral Palsy are distance-dependent.

机构信息

School of Health Care Science, Manchester Metropolitan University, Manchester M1 5GD, UK.

出版信息

Res Dev Disabil. 2012 May-Jun;33(3):971-81. doi: 10.1016/j.ridd.2012.01.006. Epub 2012 Feb 2.

Abstract

This study examined the arm position sense in children with Spastic Hemiparetic Cerebral Palsy (SHCP) and typically developing children (TD) by means of a contralateral matching task. This task required participants to match the position of one arm with the position of the other arm for different target distances and from different starting positions. Results showed that children with SHCP exhibited with both arms larger matching errors than the TD group, but only when the distance between the arms at the start of the movement was large. In addition, the difference in errors between the less-impaired and the impaired limb changed as a function of the distance in the SHCP group whereas no interlimb differences were found in the TD group. Finally, spasticity and restricted range of motion in children with SHCP were not related to the proportion of undershoot and size of absolute error. This suggests that SHCP could be associated with sensory problems in conjunction with their motor problems. In conclusion, the current study showed that accurate matching of the arms is greatly impaired in SHCP when compared to TD children, irrespective of which arm is used. Moreover, this deficit is particularly present for large movement amplitudes.

摘要

本研究采用对侧匹配任务,考察痉挛型偏瘫脑瘫(SHCP)患儿和正常发育儿童(TD)的手臂位置感。该任务要求参与者将一只手臂的位置与另一只手臂的位置相匹配,目标距离和起始位置不同。结果表明,SHCP 患儿的双侧手臂在运动起始时手臂之间距离较大时,匹配误差大于 TD 组,但只有在运动起始时手臂之间距离较大时才会出现这种情况。此外,SHCP 组中,非受累侧和受累侧手臂之间的误差差异随距离的变化而变化,而 TD 组中则没有发现这种四肢间差异。最后,SHCP 患儿的痉挛和运动范围受限与运动不足的比例和绝对误差的大小无关。这表明,SHCP 可能与运动障碍有关,同时还存在感觉问题。总之,本研究表明,与 TD 儿童相比,SHCP 儿童的手臂准确匹配受到严重损害,无论使用哪只手臂。此外,这种缺陷在大运动幅度时更为明显。

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