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2至4岁健康儿童中与平衡相关的步态参数。

Gait parameters associated with balance in healthy 2- to 4-year-old children.

作者信息

Guffey Keegan, Regier Michael, Mancinelli Corrie, Pergami Paola

机构信息

Department of Pediatrics, Child Neurology, West Virginia University, P.O. Box 9214, 1 Medical Center Drive, Morgantown, WV 26506, United States.

Department of Biostatistics, West Virginia University, P.O. Box 9190, G104F HSC North, Morgantown, WV 26506, United States.

出版信息

Gait Posture. 2016 Jan;43:165-9. doi: 10.1016/j.gaitpost.2015.09.017. Epub 2015 Sep 30.

Abstract

The use of validated measurements of gait and balance are crucial to establish baseline function and assess effectiveness of therapeutic interventions. Gait in children changes with motor development requiring frequent observations to effectively track progress. Standardized baseline spatiotemporal measurements and a greater understanding of the relationship between gait and balance would provide important feedback to clinicians regarding the effectiveness of rehabilitation and guide treatment modifications. 84 subjects (2.0-4.9 years) walked along the GAITRite(®), a walkway that records spatiotemporal parameters. The Pediatric Balance Scale (PBS) was administered to assess balance. Comparison of spatiotemporal parameter means between age groups showed trends associated with motor development similar to the ones described in the literature such as decreased cadence and increased step/stride length with increasing age. However, no significant differences in normalized spatiotemporal parameters were found between age groups. Age, leg length, cadence, step/stride length, step/stance time, and single/double support time showed significant correlation with balance scores. When the parameters were grouped into spatial, temporal, and age-related components using principal components analysis and included in a multiple regression model, they significantly predicted 51% of the balance score variance. Age-related components most strongly predicted balance outcomes. We suggest that balance can potentially be evaluated by assessment of spatial, temporal, and age-related characteristics of gait such as step length, cadence, and leg length. This suggests the possibility of developing new gait measurement technology that could provide functional assessment and track improvements during rehabilitation regimens. If the same model can be applied to monitor treatment efficacy in children with gait abnormalities remains to be addressed.

摘要

使用经过验证的步态和平衡测量方法对于建立基线功能和评估治疗干预的有效性至关重要。儿童的步态会随着运动发育而变化,需要频繁观察以有效跟踪进展。标准化的基线时空测量以及对步态与平衡之间关系的更深入理解,将为临床医生提供有关康复效果的重要反馈,并指导治疗方案的调整。84名受试者(2.0 - 4.9岁)沿着GAITRite(®)行走,这是一种记录时空参数的通道。使用儿科平衡量表(PBS)评估平衡。年龄组之间时空参数均值的比较显示出与运动发育相关的趋势,类似于文献中描述的趋势,例如随着年龄增长步频降低,步长/步幅增加。然而,年龄组之间标准化时空参数没有显著差异。年龄、腿长、步频、步长/步幅、步长/支撑时间以及单/双支撑时间与平衡得分显著相关。当使用主成分分析将这些参数分组为空间、时间和年龄相关成分并纳入多元回归模型时,它们显著预测了51%的平衡得分方差。年龄相关成分对平衡结果的预测最强。我们建议,平衡可能可以通过评估步态的空间、时间和年龄相关特征(如步长、步频和腿长)来进行评估。这表明有可能开发新的步态测量技术,该技术可以在康复方案期间提供功能评估并跟踪改善情况。同一模型是否可用于监测步态异常儿童的治疗效果仍有待解决。

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