脑瘫患儿股四头肌痉挛：用摆锤试验测量及其与步态异常的关系
Quadriceps femoris spasticity in children with cerebral palsy: measurement with the pendulum test and relationship with gait abnormalities.
作者信息
Szopa Andrzej, Domagalska-Szopa Małgorzata, Kidoń Zenon, Syczewska Małgorzata
机构信息
School of Health Sciences, Medical University of Silesia, Katowice, Poland.
出版信息
J Neuroeng Rehabil. 2014 Dec 16;11:166. doi: 10.1186/1743-0003-11-166.
BACKGROUND
Development of a reliable and objective test of spasticity is important for assessment and treatment of children with cerebral palsy. The pendulum test has been reported to yield reliable measurements of spasticity and to be sensitive to variations in spasticity in these children. However, the relationship between the pendulum test scores and other objective measures of spasticity has not been studied. The present study aimed to assess the effectiveness of an accelerometer-based pendulum test as a measurement of spasticity in CP, and to explore the correlation between the measurements of this test and the global index of deviation from normal gait in in children with cerebral palsy.
METHODS
We studied thirty-six children with cerebral palsy, including 18 with spastic hemiplegia and 18 with spastic diplegia, and a group of 18 typically-developing children. Knee extensor spasticity was assessed bilaterally using the accelerometer-based pendulum test and three-dimensional gait analysis. The Gillette Gait Index was calculated from the results of the gait analysis.
RESULTS
The data from the accelerometer-based pendulum test could be used to distinguish between able-bodied children and children with cerebral palsy. Additionally, two of the measurements, first swing excursion and relaxation index, could be used to differentiate the degree of knee extensor spasticity in the children with cerebral palsy. Only a few moderate correlations were found between the Gillette Gait Index and the pendulum test data.
CONCLUSIONS
This study demonstrates that the pendulum test can be used to discriminate between typically developing children and children with CP, as well as between various degrees of spasticity, such as spastic hemiplegia and spastic diplegia, in the knee extensor muscle of children with CP. Deviations from normal gait in children with CP were not correlated with the results of the pendulum test.
背景
开发一种可靠且客观的痉挛测试方法对于评估和治疗脑瘫儿童至关重要。据报道，钟摆试验能够得出可靠的痉挛测量结果，并且对这些儿童的痉挛变化敏感。然而，钟摆试验得分与其他痉挛客观测量指标之间的关系尚未得到研究。本研究旨在评估基于加速度计的钟摆试验作为测量脑瘫患儿痉挛的有效性，并探讨该试验测量结果与脑瘫患儿正常步态偏离总体指数之间的相关性。
方法
我们研究了36名脑瘫儿童，其中包括18名痉挛性偏瘫患儿和18名痉挛性双瘫患儿，以及一组18名发育正常的儿童。使用基于加速度计的钟摆试验和三维步态分析对双侧膝伸肌痉挛进行评估。根据步态分析结果计算吉列步态指数。
结果
基于加速度计的钟摆试验数据可用于区分健全儿童和脑瘫儿童。此外，其中两项测量指标，即首次摆动幅度和松弛指数，可用于区分脑瘫患儿膝伸肌痉挛的程度。吉列步态指数与钟摆试验数据之间仅发现了一些中度相关性。
结论
本研究表明，钟摆试验可用于区分发育正常的儿童和脑瘫儿童，以及脑瘫患儿膝伸肌不同程度的痉挛，如痉挛性偏瘫和痉挛性双瘫。脑瘫患儿的步态偏离与钟摆试验结果无关。
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