Klotz Matthias C M, van Drongelen Stefan, Rettig Oliver, Wenger Patrick, Gantz Simone, Dreher Thomas, Wolf Sebastian I
Department of Orthopaedic and Trauma Surgery, Heidelberg University Hospital, Heidelberg, Germany.
Res Dev Disabil. 2014 Nov;35(11):2950-7. doi: 10.1016/j.ridd.2014.07.021. Epub 2014 Aug 9.
Restrictions in range of motion of the upper extremity are common in patients with unilateral cerebral palsy (CP). The purpose of this study was to investigate movement deviations of the upper extremity in children with unilateral CP by means of 3D motion capture as well as by the use of easy to use scores and questionnaires (MACS, MRC, MAS, ABILHAND-Kids). 16 children with a spastic, unilateral CP were included and compared to a group of 17 typically developing adolescents (TD). The movement time and range of motion (ROM) of six uni- and bimanual daily tasks were compared and correlated with the scores and questionnaires. Movement times increased significantly with involvement according to MACS in all tasks. The restrictions in ROM were pronounced in the forearm. As a compensatory mechanism the children of the MACS 2 and 3 groups showed increased trunk movement. Furthermore, there was a positive correlation between the MACS and the ABILHAND-Kids Questionnaire. In contrast to previous studies, which reported a correlation between the restrictions in ROM and the MACS, this study showed no consistent correlation between the restrictions in ROM neither with the MACS nor with the ABILHAND-Kids. While the MACS and the ABILHAND-Kids function as a simple rating tool for clinical use, the detailed analysis of different daily tasks using 3-D-motion capture provides more detailed information about the movement deviations and spatiotemporal parameters.
上肢运动范围受限在单侧脑瘫（CP）患者中很常见。本研究的目的是通过三维运动捕捉以及使用易于使用的评分和问卷（MACS、MRC、MAS、ABILHAND-Kids）来研究单侧CP儿童上肢的运动偏差。纳入了16名痉挛型单侧CP儿童，并与一组17名发育正常的青少年（TD）进行比较。比较了六项单手和双手日常任务的运动时间和运动范围（ROM），并将其与评分和问卷进行关联。根据MACS，所有任务中的运动时间随着受累程度显著增加。ROM受限在前臂最为明显。作为一种代偿机制，MACS 2组和3组的儿童表现出躯干运动增加。此外，MACS与ABILHAND-Kids问卷之间存在正相关。与之前报道ROM受限与MACS之间存在相关性的研究不同，本研究表明ROM受限与MACS或ABILHAND-Kids之间均无一致的相关性。虽然MACS和ABILHAND-Kids可作为临床使用的简单评级工具，但使用三维运动捕捉对不同日常任务进行详细分析可提供有关运动偏差和时空参数的更详细信息。
