痉挛型脑瘫患儿在步态中，踝足背屈活动度降低与膝关节屈曲增加有关。

Decrease in ankle-foot dorsiflexion range of motion is related to increased knee flexion during gait in children with spastic cerebral palsy.

作者信息

Maas Josina C, Huijing Peter A, Dallmeijer Annet J, Harlaar Jaap, Jaspers Richard T, Becher Jules G

机构信息

Department of Rehabilitation Medicine, MOVE Research Institute Amsterdam, The EMGO+ Institute for Health and Care Research, VU University Medical Center, De Boelelaan 1117, 1081HV Amsterdam, The Netherlands.

MOVE Research Institute Amsterdam, Faculty of Human Movement Sciences, VU University, Van der Boechorststraat 9, 1081BT Amsterdam, The Netherlands.

出版信息

J Electromyogr Kinesiol. 2015 Apr;25(2):339-46. doi: 10.1016/j.jelekin.2014.10.015. Epub 2014 Dec 9.

DOI:10.1016/j.jelekin.2014.10.015

PMID:25553965

Abstract

PURPOSE

To determine the effects of decreased ankle-foot dorsiflexion (A-Fdf) range of motion (ROM) on gait kinematics in children with spastic cerebral palsy (SCP).

METHODS

All participants were children with spastic cerebral palsy (n = 10) who walked with knee flexion in midstance. Data were collected over 2-5 sessions, at 3-monthly intervals. A-Fdf ROM was quantified using a custom-designed hand-held ankle dynamometer that exerted 4 Nm at the ankle. Ankle-foot and knee angles during gait were quantified on sagittal video recordings. Linear regression (cross-sectional analysis) and General Estimation Equation analysis (longitudinal analysis) were performed to assess relationships between (change in) A-Fdf ROM and (change in) ankle-foot and knee angle during gait.

RESULTS

Cross-sectional analysis showed a positive relationship between A-Fdf ROM and both ankle-foot angle in midstance and terminal swing. Longitudinal analysis showed a positive relationship between individual decreases in A-Fdf ROM and increases of knee flexion during gait (lowest knee angle in terminal stance and angle in terminal swing).

CONCLUSION

For this subgroup of SCP children, our results indicate that while changes in ankle angles during gait are unrelated to changes in A-Fdf ROM, changes in knee angles are related to changes in A-Fdf ROM.

摘要

目的

确定踝关节背屈（A-Fdf）活动范围（ROM）减小对痉挛型脑性瘫痪（SCP）患儿步态运动学的影响。

方法

所有参与者均为在站立中期膝关节屈曲行走的痉挛型脑性瘫痪患儿（n = 10）。数据在2至5个疗程中收集，间隔为3个月。使用定制的手持式踝关节测力计在踝关节施加4 Nm的力来量化A-Fdf ROM。在矢状面视频记录上量化步态期间的踝足和膝关节角度。进行线性回归（横断面分析）和广义估计方程分析（纵向分析）以评估步态期间A-Fdf ROM（变化）与踝足和膝关节角度（变化）之间的关系。