Martini Joyce, Hukuda Michele Emy, Caromano Fátima Aparecida, Favero Francis Meire, Fu Carolina, Voos Mariana Callil
Department of Physical Therapy, Speech Therapy and Occupational Therapy, Faculty of Medicine, University of São Paulo , São Paulo , Brazil and.
Physiother Theory Pract. 2015 Mar;31(3):173-81. doi: 10.3109/09593985.2014.989294. Epub 2014 Dec 24.
The measurement of time and compensatory movements for functional tasks is not frequently used to evaluate children with Duchenne muscular dystrophy (DMD). As muscle weakness progresses, new synergies (compensatory movements) are selected to perform the tasks, demanding higher times.
The present study aimed to describe the timed motor performance of rising from the floor to standing, sitting down on the floor from standing, climbing up four steps and climbing down four steps 18 and 6 months prior to gait loss and to investigate possible relationships between these timed performances, the compensatory movements and the Vignos Scale (VS) scores.
Fourteen children with DMD (mean age: 9.6) were videotaped performing the tasks. Spearman correlation tests investigated the relationships between the times, compensatory movements (scored by FES-DMD) and VS.
The timed performance and the compensatory movements for rising from the floor, climbing up and climbing down steps varied broadly and were correlated to each other among patients with DMD at 18 and 6 months prior to gait loss. The relationship was not found for sitting on the floor. The timed performance and compensatory movements for climbing up and down steps also correlated to the VS.
Rising from the floor, climbing up, and climbing down steps have some components in common, such as the demand for muscle strength and the recruitment of compensatory muscle synergies, as DMD progresses. To sit down on the floor, some children let themselves fall, resulting in a faster performance, but more compensatory movements.
对于杜氏肌营养不良症（DMD）患儿，功能任务的时间测量和代偿性动作并不常用于评估。随着肌肉无力的进展，会选择新的协同动作（代偿性动作）来完成任务，这需要更长时间。
本研究旨在描述在步态丧失前18个月和6个月时，从地面起身站立、从站立姿势坐到地面、爬上四级台阶和爬下四级台阶的定时运动表现，并研究这些定时表现、代偿性动作与维格诺斯量表（VS）评分之间的可能关系。
对14名DMD患儿（平均年龄：9.6岁）完成任务的过程进行录像。采用斯皮尔曼相关性检验来研究时间、代偿性动作（由FES-DMD评分）和VS之间的关系。
在步态丧失前18个月和6个月时，DMD患儿从地面起身、爬上和爬下台阶的定时表现和代偿性动作差异很大，且相互关联。而坐到地面的情况未发现这种关系。爬上和爬下台阶的定时表现及代偿性动作也与VS相关。
随着DMD病情进展，从地面起身、爬上和爬下台阶有一些共同的要素，比如对肌肉力量的需求以及代偿性肌肉协同动作的募集。有些患儿为了更快坐到地面会让自己倒下，这样用时更短，但代偿性动作更多。
