Centre for Clinical Research, Uppsala University, Central Hospital, Västerås, Sweden; Department of Orthopaedics, Lund University, Skåne University Hospital, Lund, Sweden.
Dev Med Child Neurol. 2013 Nov;55(11):1009-15. doi: 10.1111/dmcn.12199. Epub 2013 Jul 9.
The purpose was to describe posture, ability to change position, and association between posture and contractures, hip dislocation, scoliosis, and pain in young adults with cerebral palsy (CP).
Cross-sectional data of 102 people (63 males, 39 females; age range 19-23 y, median 21 y) out of a total population with CP was analysed in relation to Gross Motor Function Classification System (GMFCS) levels I (n=38), II (n=21), III (n=13), IV (n=10), and V (n=20). The CP subtypes were unilateral spastic (n=26), bilateral spastic (n=45), ataxic (n=12), and dyskinetic CP (n=19). The Postural Ability Scale was used to assess posture. The relationship between posture and joint range of motion, hip dislocation, scoliosis, and pain was analysed using logistic regression and Spearman's correlation.
At GMFCS levels I to II, head and trunk asymmetries were most common; at GMFCS levels III to V postural asymmetries varied with position. The odds ratios (OR) for severe postural asymmetries were significantly higher for those with scoliosis (OR=33 sitting), limited hip extension (OR=39 supine), or limited knee extension (OR=37 standing). Postural asymmetries correlated to hip dislocations: supine (r(s) =0.48), sitting (r(s) =0.40), standing (r(s) =0.41), and inability to change position: supine (r(s) =0.60), sitting (r(s) =0.73), and standing (r(s) =0.64).
Postural asymmetries were associated with scoliosis, hip dislocations, hip and knee contractures, and inability to change position.
描述姿势、改变体位的能力以及姿势与挛缩、髋关节脱位、脊柱侧凸和疼痛之间的关系，研究对象为年轻的脑瘫（CP）患者。
分析了 102 名 CP 患者（39 名女性，63 名男性；年龄 19-23 岁，中位数 21 岁）的横断面数据，与粗大运动功能分类系统（GMFCS）水平 I（n=38）、II（n=21）、III（n=13）、IV（n=10）和 V（n=20）有关。CP 亚型为单侧痉挛型（n=26）、双侧痉挛型（n=45）、共济失调型（n=12）和运动障碍型 CP（n=19）。使用姿势能力量表评估姿势。使用逻辑回归和斯皮尔曼相关分析来分析姿势与关节活动范围、髋关节脱位、脊柱侧凸和疼痛之间的关系。
在 GMFCS 水平 I 至 II 中，头和躯干的不对称最为常见；在 GMFCS 水平 III 至 V 中，姿势不对称随体位而变化。严重姿势不对称的比值比（OR）在患有脊柱侧凸（OR=33 坐姿）、髋关节伸展受限（OR=39 仰卧位）或膝关节伸展受限（OR=37 站立位）的患者中显著升高。姿势不对称与髋关节脱位相关：仰卧位（r(s) =0.48）、坐姿（r(s) =0.40）、站位（r(s) =0.41）以及无法改变体位：仰卧位（r(s) =0.60）、坐姿（r(s) =0.73）和站位（r(s) =0.64）。
姿势不对称与脊柱侧凸、髋关节脱位、髋关节和膝关节挛缩以及无法改变体位有关。
