Dziuba Alicja, Bober Tadeusz, Kobel-Buys Krystyna, Stempień Marlena
University School of Physical Education, Institute of Biomechanics, Wrocław, Poland.
Acta Bioeng Biomech. 2013;15(2):105-11.
Gait analysis is an objective tool for the clinical assessment of locomotor activity in children with cerebral palsy (CP). Correct diagnosis and properly planned rehabilitation are necessary for enhanced motor functions in persons suffering from cerebral palsy. Orthoses, orthopedic operations, medications and physiotherapy are the most common treatments. However, there is still a lack of objective methods for assessing motor behavior and monitoring the progress of recovery. The aim of the study was to use the ground reaction force patterns generated during walking to create the Integral Method (IM), which could become an objective tool that could supplement the functional classification of CP children based on the Gross Motor Function Classification System (GMFCS). A total of 15 healthy children and 34 children with CP who walk independently participated in the study. A Kistler force plate and GRFintegral software were used. Of the 34 measurements based on the IM for CP children, 17 matched the level assigned by the GMFCS, 2 children were assigned a higher level, and 15 were assigned a lower level. Pearson's correlation coefficient between the IM and the GMFCS was moderate (r = 0.61, p ≤ 0.01). Asymmetry was found in 11 cases. The IM supplements the GMFCS and is an objective and quantitative assessment of motor abilities. The method allows for the detection of asymmetry, diagnosis of the improvement of gait pattern and assessment of foot support technique. With the appropriate software, the IM provides pediatricians, neurologists, orthopedists, surgeons and physiotherapists with a simple and fast way to assess gait.
步态分析是对脑瘫（CP）患儿运动活动进行临床评估的一种客观工具。正确诊断和合理规划康复治疗对于改善脑瘫患者的运动功能至关重要。矫形器、骨科手术、药物治疗和物理治疗是最常见的治疗方法。然而，目前仍缺乏评估运动行为和监测恢复进程的客观方法。本研究的目的是利用行走过程中产生的地面反作用力模式创建积分法（IM），该方法可成为一种客观工具，用以补充基于粗大运动功能分类系统（GMFCS）对脑瘫患儿进行的功能分类。共有15名健康儿童和34名能够独立行走的脑瘫儿童参与了本研究。使用了奇石乐测力板和GRFintegral软件。在基于IM对34名脑瘫患儿进行的测量中，17名患儿的测量结果与GMFCS指定的水平相符，2名患儿被指定为更高水平，15名患儿被指定为更低水平。IM与GMFCS之间的皮尔逊相关系数为中等（r = 0.61，p≤0.01）。在11例中发现了不对称情况。IM补充了GMFCS，是对运动能力的一种客观定量评估。该方法能够检测不对称情况、诊断步态模式的改善以及评估足部支撑技术。借助适当的软件，IM为儿科医生、神经科医生、骨科医生、外科医生和物理治疗师提供了一种简单快捷的步态评估方法。
