Tsai Liang-Ching, Ren Yupeng, Gaebler-Spira Deborah J, Revivo Gadi A, Zhang Li-Qun
From the Department of Physical Therapy, Georgia State University, Atlanta, Georgia (L-CT); Rehabilitation Institute of Chicago, Chicago, Illinois (YR, DJG-S, GAR, L-QZ); Departments of Physical Medicine and Rehabilitation (DJG-S, GAR, L-QZ), Biomedical Engineering (L-QZ), and Orthopaedic Surgery (L-QZ), Northwestern University, Chicago, Illinois; and NorthShore University HealthSystem, Chicago, Illinois (L-QZ).
Am J Phys Med Rehabil. 2017 Jul;96(7):515-522. doi: 10.1097/PHM.0000000000000632.
This preliminary study examined the effects of off-axis elliptical training on reducing transverse-plane gait deviations and improving gait function in 8 individuals with cerebral palsy (CP) (15.5 ± 4.1 years) who completed an training program using a custom-made elliptical trainer that allows transverse-plane pivoting of the footplates during exercise. Lower-extremity off-axis control during elliptical exercise was evaluated by quantifying the root-mean-square and maximal angular displacement of the footplate pivoting angle. Lower-extremity pivoting strength was assessed. Gait function and balance were evaluated using 10-m walk test, 6-minute-walk test, and Pediatric Balance Scale. Toe-in angles during gait were quantified. Participants with CP demonstrated a significant decrease in the pivoting angle (root mean square and maximal angular displacement; effect size, 1.00-2.00) and increase in the lower-extremity pivoting strength (effect size = 0.91-1.09) after training. Reduced 10-m walk test time (11.9 ± 3.7 seconds vs. 10.8 ± 3.0 seconds; P = 0.004; effect size = 1.46), increased Pediatric Balance Scale score (43.6 ± 12.9 vs. 45.6 ± 10.8; P = 0.042; effect size = 0.79), and decreased toe-in angle (3.7 ± 10.5 degrees vs. 0.7 ± 11.7 degrees; P = 0.011; effect size = 1.22) were observed after training. We present an intervention to challenge lower-extremity off-axis control during a weight-bearing and functional activity for individuals with CP. Our preliminary findings suggest that this intervention was effective in enhancing off-axis control, gait function, and balance and reducing in-toeing gait in persons with CP.
这项初步研究考察了离轴椭圆训练对8名脑瘫（CP）患者（年龄15.5±4.1岁）减少横平面步态偏差和改善步态功能的影响。这些患者完成了一项使用定制椭圆训练机的训练计划，该训练机在运动过程中允许踏板进行横平面旋转。通过量化踏板旋转角度的均方根和最大角位移来评估椭圆运动过程中的下肢离轴控制。评估了下肢旋转力量。使用10米步行测试、6分钟步行测试和儿科平衡量表评估步态功能和平衡。量化了步态中的内收角。CP患者在训练后踏板旋转角度（均方根和最大角位移；效应大小为1.00 - 2.00）显著降低，下肢旋转力量增加（效应大小 = 0.91 - 1.09）。训练后观察到10米步行测试时间缩短（11.9±3.7秒对10.8±3.0秒；P = 0.004；效应大小 = 1.46），儿科平衡量表得分增加（43.6±12.9对45.6±10.8；P = 0.042；效应大小 = 0.79），内收角减小（3.7±10.5度对0.7±11.7度；P = 0.011；效应大小 = 1.22）。我们提出了一种干预措施，以在负重和功能活动中挑战CP患者的下肢离轴控制。我们的初步研究结果表明，这种干预措施在增强CP患者的离轴控制、步态功能和平衡以及减少内收步态方面是有效的。
