Adair Brooke, Rodda Jillian, McGinley Jennifer L, Graham H Kerr, Morris Meg E
Centre for Disability and Development Research, Australian Catholic University, Fitzroy, Vic., Australia.
Hugh Williamson Gait Laboratory, The Royal Children's Hospital, Parkville, Vic., Australia.
Dev Med Child Neurol. 2016 Aug;58(8):829-35. doi: 10.1111/dmcn.13082. Epub 2016 Feb 22.
To examine the kinematic gait deviations at the trunk and pelvis of children with hereditary spastic paraplegia (HSP).
This exploratory observational study quantified gait kinematics for the trunk and pelvis from 11 children with HSP (7 males, 4 females) using the Gait Profile Score and Gait Variable Scores (GVS), and compared the kinematics to data from children with typical development using a Mann-Whitney U test.
Children with HSP (median age 11y 4mo, interquartile range 4y) demonstrated large deviations in the GVS for the trunk and pelvis in the sagittal and coronal planes when compared to the gait patterns of children with typical development (p=0.010-0.020). Specific deviations included increased range of movement for the trunk in the coronal plane and increased excursion of the trunk and pelvis in the sagittal plane. In the transverse plane, children with HSP demonstrated later peaks in posterior pelvic rotation.
The kinematic gait deviations identified in this study raise questions about the contribution of muscle weakness in HSP. Further research is warranted to determine contributing factors for gait dysfunction in HSP, especially the relative influence of spasticity and weakness.
研究遗传性痉挛性截瘫（HSP）患儿躯干和骨盆的运动步态偏差。
这项探索性观察研究使用步态轮廓评分和步态变量评分（GVS）对11名HSP患儿（7名男性，4名女性）的躯干和骨盆步态运动学进行了量化，并使用曼-惠特尼U检验将这些运动学数据与发育正常儿童的数据进行了比较。
与发育正常儿童的步态模式相比，HSP患儿（中位年龄11岁4个月，四分位间距4岁）在矢状面和冠状面的躯干和骨盆GVS中表现出较大偏差（p=0.010-0.020）。具体偏差包括冠状面躯干运动范围增加以及矢状面躯干和骨盆偏移增加。在横断面中，HSP患儿在骨盆后旋方面表现出较晚的峰值。
本研究中确定的运动步态偏差引发了关于HSP中肌肉无力作用的问题。有必要进行进一步研究以确定HSP步态功能障碍的促成因素，尤其是痉挛和无力的相对影响。
