Wickstrom Jordan, Stergiou Nick, Kyvelidou Anastasia
University of North Carolina at Greensboro, 1400 Spring Garden Street, Greensboro, NC 27412 USA.
University of Nebraska Omaha, 6160 University Drive South, Omaha, NE 68182 USA.
Gait Posture. 2017 Jul;56:8-13. doi: 10.1016/j.gaitpost.2017.04.031. Epub 2017 Apr 27.
Cerebral palsy (CP) impairs an individual's ability to move and control one's posture. Unfortunately, the signs and symptoms of CP may not be apparent before age two. Evaluating sitting posture is a potential way to assess the developing mechanisms that contribute to CP. The purpose of this project was to determine the reliability of linear and nonlinear measures, including inter- and intrastage reliability, when used to analyze the center of pressure (COP) time series during the stages of sitting development in children with typical development (TD) and with/at-risk for cerebral palsy (CP). We hypothesized that nonlinear tools would be more reliable than linear tools in assessing childrens' sitting development, and reliability would increase with development. COP data was recorded for three trials at eight sessions. Linear parameters used were root mean square, range of sway for the anterior-posterior (AP) and medial-lateral (ML) directions, and sway path. Nonlinear parameters used were Approximate Entropy, the largest Lyapunov Exponent, and Correlation Dimension for the AP and ML direction. Participants consisted of 33 children with TD and 26 children with/at-risk for CP. Our results determined that COP is a moderately reliable method for assessing the development of sitting postural control in stages in both groups. Thus, clinicians may be able to use measures from COP data across stages to assess the efficacy of therapeutic interventions that are intended to improve sitting postural abilities in children with/at-risk for CP.
脑瘫（CP）会损害个体的运动能力和姿势控制能力。不幸的是，脑瘫的体征和症状在两岁之前可能并不明显。评估坐姿是评估导致脑瘫的发育机制的一种潜在方法。本项目的目的是确定线性和非线性测量方法的可靠性，包括阶段间和阶段内的可靠性，这些方法用于分析典型发育（TD）儿童以及患有脑瘫（CP）或有患脑瘫风险的儿童在坐位发育阶段的压力中心（COP）时间序列。我们假设在评估儿童坐位发育时，非线性工具比线性工具更可靠，并且可靠性会随着发育而提高。在八个时间段内记录了三次试验的COP数据。使用的线性参数有均方根、前后（AP）和内外侧（ML）方向的摆动范围以及摆动路径。使用的非线性参数有近似熵、最大Lyapunov指数以及AP和ML方向的关联维数。参与者包括33名TD儿童和26名患有CP或有患CP风险的儿童。我们的结果表明，COP是评估两组儿童坐位姿势控制阶段性发育的一种中等可靠的方法。因此，临床医生或许能够使用跨阶段的COP数据测量方法来评估旨在改善患有CP或有患CP风险儿童坐位姿势能力的治疗干预措施的效果。
