Monbaliu Elegast, De Cock Paul, Mailleux Lisa, Dan Bernard, Feys Hilde
Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium.
Department of Public Health and Primary Care Leuven, KU Leuven - University of Leuven, Leuven, Belgium.
Eur J Paediatr Neurol. 2017 Mar;21(2):327-335. doi: 10.1016/j.ejpn.2016.09.003. Epub 2016 Sep 23.
To relate dystonia and choreoathetosis with activity, participation and quality of life (QOL) in children and youth with dyskinetic Cerebral Palsy (CP).
Fifty-four participants with dyskinetic CP (mean age 14y6m, SD 4y2m, range 6-22y) were included. The Dyskinesia Impairment Scale (DIS) was used to evaluate dystonia and choreoathetosis. Activity, participation and quality of life (QOL) were assessed with the Gross Motor Function Measure (GMFM), the Functional Mobility Scale (FMS), the Jebsen-Taylor Hand Function Test (JTT), the ABILHAND-Kids Questionnaire (ABIL-K), the Life Habits Kids (LIFE-H) and the Quality of Life Questionnaire for children with CP (CP-QOL). Spearman's rank correlation coefficient (r) was used to assess the relationship between the movement disorders and activity, participation and QOL measures.
Significant negative correlations were found between dystonia and the activity scales with Spearman's rank correlation coefficient (r) varying between -0.65 (95% CI = -0.78 to -0.46) and -0.71 (95% CI = -0,82 to -0.55). Correlations were also found with the LIFE-H (r = -0.43; 95%CI = -0.64 to -0.17) and the CP-QOL (r = -0.32; 95%CI = -0.56 to -0.03). As far as choreoathetosis is concerned, no or only weak relationships were found with the activity, participation and quality of life scales.
This cross-sectional study is the first to examine the relationship of dystonia and choreoathetosis in dyskinetic CP with the level of activity, participation and QOL. The results revealed dystonia has a higher impact on activity, participation and quality of life than choreoathetosis. These findings seem to suggest it is necessary to first focus on dystonia reducing intervention strategies and secondly on choreoathetosis.
探讨运动障碍型脑性瘫痪（CP）儿童和青少年的肌张力障碍及舞蹈样手足徐动症与活动、参与及生活质量（QOL）之间的关系。
纳入54例运动障碍型CP患者（平均年龄14岁6个月，标准差4岁2个月，范围6 - 22岁）。采用运动障碍损害量表（DIS）评估肌张力障碍和舞蹈样手足徐动症。通过粗大运动功能测量（GMFM）、功能移动量表（FMS）、杰布森 - 泰勒手功能测试（JTT）、儿童手功能问卷（ABIL - K）、儿童生活习惯问卷（LIFE - H）以及CP儿童生活质量问卷（CP - QOL）评估活动、参与和生活质量（QOL）。采用Spearman等级相关系数（r）评估运动障碍与活动、参与及QOL测量指标之间的关系。
肌张力障碍与活动量表之间存在显著负相关，Spearman等级相关系数（r）在 - 0.65（95%可信区间 = - 0.78至 - 0.46）和 - 0.71（95%可信区间 = - 0.82至 - 0.55）之间。与LIFE - H（r = - 0.43；95%可信区间 = - 0.64至 - 0.17）和CP - QOL（r = - 0.32；95%可信区间 = - 0.56至 - 0.03）也存在相关性。就舞蹈样手足徐动症而言，与活动、参与和生活质量量表之间未发现或仅发现微弱关系。
这项横断面研究首次探讨了运动障碍型CP中肌张力障碍和舞蹈样手足徐动症与活动水平、参与及QOL之间的关系。结果显示，肌张力障碍对活动、参与和生活质量的影响高于舞蹈样手足徐动症。这些发现似乎表明，有必要首先关注降低肌张力障碍的干预策略，其次关注舞蹈样手足徐动症。
