Ko In-Hee, Kim Jung-Hee, Lee Byoung-Hee
Department of Physical Therapy, College of Health Welfare, Sahmyook University, Seoul, Korea.
J Exerc Rehabil. 2013 Jun 30;9(3):368-74. doi: 10.12965/jer.130045. eCollection 2013.
The purpose of this study was to determine the effects of the structure of skeletal muscle of lower extremities on function, activity, and participation of children with cerebral palsy. The subjects were 38 hospitalized patients and 13 infants with normal development. The following clinical measures were used for assessment of activity daily living and functional level of gross motor: Gross Motor Function Classification System (GMFCS), Gross Motor Function Measure (GMFM), Wee Functional Independence Measure (WeeFIM), International Classification of Functioning Child and Youth (ICF CY). Muscle thickness and strength of knee extensor and ankle extensor were collected using ultrasonography and manual muscle tester. Following the results of ICF CY evaluation for body function, activity, learning and application of knowledge, communication and environmental factors showed a decline (P< 0.05). Significant differences in the thickness of muscle was observed according to the GMFCS level, thickness of knee extensor and ankle extensor of cerebral palsy (P< 0.05), and clauses of self-care, activity, mobility, ambulation, communication, and social acknowledgement (P< 0.05). Following analysis, results showed negative correlation in the thickness of muscle, muscle strength, major motor function, daily activity and participation; the score of ICF-CY was shown to decline due to the high score for differences in thickness of muscle, muscle strength, WeeFIM, and GMFM. The thickness and muscle strength of lower extremities affect main functions of the body and improvement of muscle strength of lower extremities may have positive effects on social standards such as activity and participation of cerebral palsy.
本研究的目的是确定下肢骨骼肌结构对脑瘫患儿功能、活动和参与度的影响。研究对象为38名住院患者和13名发育正常的婴儿。采用以下临床测量方法评估日常生活活动和粗大运动功能水平:粗大运动功能分类系统(GMFCS)、粗大运动功能测量(GMFM)、小儿功能独立性测量(WeeFIM)、儿童及青少年国际功能分类(ICF CY)。使用超声检查和徒手肌力测试仪收集膝伸肌和踝伸肌的肌肉厚度和力量。根据ICF CY对身体功能、活动、知识学习与应用、沟通和环境因素的评估结果显示有所下降(P<0.05)。根据GMFCS水平、脑瘫患儿膝伸肌和踝伸肌的厚度,以及自我护理、活动、移动、步行、沟通和社会认可等方面,观察到肌肉厚度存在显著差异(P<0.05)。经过分析,结果显示肌肉厚度、肌肉力量、主要运动功能、日常活动和参与度之间呈负相关;由于肌肉厚度、肌肉力量、WeeFIM和GMFM差异得分较高,ICF-CY评分呈下降趋势。下肢的肌肉厚度和力量会影响身体的主要功能,提高下肢肌肉力量可能对脑瘫患儿的活动和参与度等社会标准产生积极影响。