Department of Physical Therapy, Temple University, Philadelphia, PA 19140, USA.
IEEE Trans Neural Syst Rehabil Eng. 2013 Mar;21(2):218-24. doi: 10.1109/TNSRE.2013.2246583.
We employed a virtual environment to examine the postural behaviors of adults with cerebral palsy (CP). Four adults with CP (22-32 years) and nine healthy adults (21-27 years) were tested with a Rod and Frame protocol. They then stood quietly on a platform within a three-wall virtual environment. The platform was either kept stationary or tilted 3(°) into dorsiflexion in the dark or with pitch up and down visual field rotations at 30(°)/s and 45(°)/s. While the visual field rotated, the platform was held tilted for 30 s and then slowly returned to a neutral position over 30 s. Center of pressure (CoP) was recorded and center of mass (CoM) as well as trunk and ankle angles were calculated. Electromyography (EMG) responses of the ankle and the hip muscles were recorded and analyzed using wavelets. Larger angular deviations from vertical and horizontal in the Rod and Frame test indicated that adults with CP were more visually dependent than healthy adults. Adults with CP had difficulty maintaining balance when standing on a stationary platform during pitch upward rotation of the visual scene. When the platform was tilted during visual field rotations, adults with CP took longer to stabilize their posture and had larger CoM oscillations than when in the dark. The inability to compensate for busy visual environments could impede maintenance of functional locomotion in adults with CP. Employing a visual field stimulus for assessment and training of postural behaviors would be more meaningful than testing in the dark.
我们采用虚拟现实环境来研究脑瘫（CP）成人的姿势行为。四名 CP 成人（22-32 岁）和九名健康成人（21-27 岁）接受了棒框测试。然后，他们在三面墙的虚拟现实环境中的平台上安静站立。平台要么保持静止，要么在黑暗中或在 30（°）/s 和 45（°）/s 的俯仰视野旋转时倾斜 3（°）至背屈。当视野旋转时，平台倾斜 30 秒，然后在 30 秒内缓慢返回中立位置。记录了中心压力（CoP），并计算了质心（CoM）以及躯干和踝关节角度。记录并分析了踝关节和髋关节肌肉的肌电图（EMG）反应，使用了小波。棒框测试中垂直和水平的角度偏差越大，表明 CP 成人比健康成人更依赖视觉。当视觉场景向上俯仰时，CP 成人在静止平台上站立时难以保持平衡。当视野旋转时平台倾斜时，CP 成人需要更长的时间来稳定姿势，并且 CoM 振荡幅度比在黑暗中更大。无法补偿繁忙的视觉环境可能会阻碍 CP 成人的功能性运动维持。采用视觉刺激进行姿势行为评估和训练将比在黑暗中测试更有意义。
