Department of Rehabilitation Sciences, KU Leuven, Tervuursevest 101, 3001 Heverlee, Belgium.
Gait Posture. 2013 Sep;38(4):770-6. doi: 10.1016/j.gaitpost.2013.03.019. Epub 2013 Apr 15.
This study uses a recently developed trunk model to determine which head and trunk kinematic parameters differentiate children with spastic diplegia from typically developing (TD) children while walking. Differences in head and trunk parameters in relation to the severity of the motor involvement (GMFCS levels) were additionally examined. The trunk model consisted of five segments (pelvis, thorax, head, shoulder line, spine). Discrete kinematic parameters (ROM, mean position) and angular waveforms were compared between 20 children with spastic diplegia (age 9.8 years±2.9 years; GMFCS I: n=10, GMFCS II: n=10) and 20 individually age-matched TD children (9.7 years±3 years). A new measure for overall trunk pathology, the trunk profile score (TPS), was proposed and included in the comparative analysis. Compared to TD children, children with GMFCS II showed a significantly higher TPS and increased ROM for pelvis tilt, for thorax and head in nearly all planes, and the angle of kyphosis. In children with GMFCS I, only ROM of thorax lateral bending was significantly increased. Sagittal ROM differentiated best between GMFCS levels, with higher ROM found in children with GMFCS II. Current results provide new insights into head and trunk kinematics during gait in children with spastic diplegia.
本研究使用新开发的躯干模型来确定在行走时，哪些头部和躯干运动学参数可将痉挛性双瘫儿童与正常发育（TD）儿童区分开来。此外，还研究了头部和躯干参数与运动障碍严重程度（GMFCS 水平）的关系。躯干模型由五个部分（骨盆、胸部、头部、肩部线、脊柱）组成。对 20 名痉挛性双瘫儿童（年龄 9.8 岁±2.9 岁；GMFCS I：n=10，GMFCS II：n=10）和 20 名年龄匹配的 TD 儿童（9.7 岁±3 岁）的离散运动学参数（ROM、平均位置）和角波进行了比较。提出了一个新的整体躯干病理测量方法，即躯干轮廓评分（TPS），并将其纳入了对比分析。与 TD 儿童相比，GMFCS II 儿童的 TPS 显著更高，骨盆倾斜、几乎所有平面的胸廓和头部以及后凸角的 ROM 增加。GMFCS I 儿童中，仅胸廓侧屈的 ROM 显著增加。矢状面 ROM 可最好地区分 GMFCS 水平，GMFCS II 儿童的 ROM 更高。目前的研究结果为痉挛性双瘫儿童行走时的头部和躯干运动学提供了新的见解。
