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脑瘫儿童与正常发育儿童动态步态稳定性的差异。

Differences in the dynamic gait stability of children with cerebral palsy and typically developing children.

机构信息

Department of Physical Therapy, Munroe-Meyer Institute for Genetics and Rehabilitation, University of Nebraska Medical Center, Omaha, NE 68198-5450, United States.

出版信息

Gait Posture. 2012 Jul;36(3):600-4. doi: 10.1016/j.gaitpost.2012.05.029. Epub 2012 Jun 27.

Abstract

The aim of this investigation was to evaluate the differences in the dynamic gait stability of children with cerebral palsy (CP) and typically developing (TD) children. The participants walked on a treadmill for 2 min as a motion capture system assessed the walking kinematics. Floquet analysis was used to quantify the rate of dissipation of disturbances that were present in the walking kinematics, and the variability measures were used to assess the magnitude of the disturbances present in the step length and width. The Floquet multipliers, step width and length values were correlated with Sections D and E of the Gross Motor Function Measure (GMFM). The children with CP had a larger Floquet multiplier and used a wider step width than the TD children. The magnitude of the maximum Floquet multiplier was positively correlated with the step width. Furthermore, the magnitude of the maximum Floquet multiplier and the step width were negatively correlated with the score on Section E of the GMFM. Lastly, the children with CP used a more variable step length than the TD children. These results suggest that children with CP have poor dynamic gait stability because they require more strides to dissipate the disturbances that are present in their walking pattern. In effort to stabilize these disturbances, the children with CP appear to utilize a wider step width and modulate their step length. Overall the inability to effectively dissipate the gait disturbances may be correlated with the child's ability to perform a wide range of gross motor skills (e.g., step over obstacles, jump, walk up stairs).

摘要

本研究旨在评估脑瘫(CP)儿童与正常发育(TD)儿童在动态步态稳定性方面的差异。参与者在跑步机上行走 2 分钟,运动捕捉系统评估行走运动学。Floquet 分析用于量化行走运动学中存在的干扰的耗散率,变异性度量用于评估步长和步宽中存在的干扰的幅度。Floquet 乘数、步宽和步长值与粗大运动功能测量(GMFM)的 D 和 E 节相关。CP 患儿的 Floquet 乘数较大,步宽较 TD 儿童宽。最大 Floquet 乘数的幅度与步宽呈正相关。此外,最大 Floquet 乘数的幅度和步宽与 GMFM E 节的评分呈负相关。最后,CP 患儿的步长变异性大于 TD 儿童。这些结果表明,CP 患儿的动态步态稳定性较差,因为他们需要更多的步幅来消耗行走模式中存在的干扰。为了稳定这些干扰,CP 患儿似乎采用了更宽的步宽并调节了他们的步长。总体而言,无法有效耗散步态干扰可能与儿童执行广泛的粗大运动技能(例如,跨过障碍物、跳跃、上楼梯)的能力相关。

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