Stott N S, Reynolds N, McNair P
Starship Children's Hospital (Dr Stott), Auckland, New Zealand; Health and Physical Rehabilitation Research Centre (Ms Reynolds and Dr McNair), Auckland University of Technology, Auckland, New Zealand.
Pediatr Phys Ther. 2014 Winter;26(4):428-35. doi: 10.1097/PEP.0000000000000069.
To investigate how children with cerebral palsy (CP) adapt their gait to inclined outdoor walking conditions.
Ten children with CP, Gross Motor Function System level II, and 10 children with typical development participated. Walking velocity, stride length and ankle, knee, hip, and trunk sagittal plane angles were calculated for 4 conditions: indoor walkway, outdoor walkway, and walking up and down a 7° inclined ramp.
Gait patterns were unchanged between indoor and outdoor level walking. During up-slope walking, both groups increased hip and knee flexion at foot strike to accommodate the slope. During down-slope walking, both groups increased knee flexion in midstance to lower the body down the slope. Children with CP had greater forward trunk lean (P < .005) during up-slope walking and greater posterior trunk lean during down-slope walking (P < .0001).
Children with CP adapt to inclined walking conditions similarly to peers but use greater postural adaptations.
研究脑瘫（CP）患儿如何使其步态适应户外倾斜行走条件。
招募了10名粗大运动功能系统水平为II级的脑瘫患儿和10名发育正常的儿童参与研究。计算了4种情况下的步行速度、步长以及踝关节、膝关节、髋关节和躯干矢状面角度，这4种情况分别为：室内走道行走、室外走道行走以及在7°倾斜坡道上行走和下行。
室内和室外水平行走时的步态模式没有变化。在上坡行走时，两组在足着地时均增加了髋关节和膝关节的屈曲以适应坡度。在下坡行走时，两组在步幅中期均增加了膝关节屈曲以使身体沿斜坡下降。脑瘫患儿在上坡行走时前躯干前倾更大（P < 0.005），在下坡行走时后躯干后倾更大（P < 0.0001）。
脑瘫患儿与同龄人一样能适应倾斜行走条件，但使用了更大幅度的姿势调整。
