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脑瘫患儿的步态分析

Gait analysis in children with cerebral palsy.

作者信息

Armand Stéphane, Decoulon Geraldo, Bonnefoy-Mazure Alice

机构信息

Willy Taillard Laboratory of Kinesiology, Geneva University Hospitals and Geneva University, Switzerland.

Pediatric Orthopaedic Service, Department of Child and Adolescent, Geneva University Hospitals and Geneva University, Geneva, Switzerland.

出版信息

EFORT Open Rev. 2016 Dec 22;1(12):448-460. doi: 10.1302/2058-5241.1.000052. eCollection 2016 Dec.

Abstract

Cerebral palsy (CP) children present complex and heterogeneous motor disorders that cause gait deviations.Clinical gait analysis (CGA) is needed to identify, understand and support the management of gait deviations in CP. CGA assesses a large amount of quantitative data concerning patients' gait characteristics, such as video, kinematics, kinetics, electromyography and plantar pressure data.Common gait deviations in CP can be grouped into the gait patterns of spastic hemiplegia (drop foot, equinus with different knee positions) and spastic diplegia (true equinus, jump, apparent equinus and crouch) to facilitate communication. However, gait deviations in CP tend to be a continuum of deviations rather than well delineated groups. To interpret CGA, it is necessary to link gait deviations to clinical impairments and to distinguish primary gait deviations from compensatory strategies.CGA does not tell us how to treat a CP patient, but can provide objective identification of gait deviations and further the understanding of gait deviations. Numerous treatment options are available to manage gait deviations in CP. Generally, treatments strive to limit secondary deformations, re-establish the lever arm function and preserve muscle strength.Additional roles of CGA are to better understand the effects of treatments on gait deviations. Cite this article: Armand S, Decoulon G, Bonnefoy-Mazure A. Gait analysis in children with cerebral palsy. 2016;1:448-460. DOI: 10.1302/2058-5241.1.000052.

摘要

脑瘫(CP)患儿存在复杂且多样的运动障碍,这些障碍会导致步态异常。需要进行临床步态分析(CGA)来识别、理解并支持对CP患儿步态异常的管理。CGA评估大量有关患者步态特征的定量数据,如视频、运动学、动力学、肌电图和足底压力数据。CP常见的步态异常可分为痉挛性偏瘫的步态模式(足下垂、不同膝关节位置的马蹄足)和痉挛性双瘫的步态模式(真性马蹄足、跳跃、假性马蹄足和蹲伏),以便于交流。然而,CP患儿的步态异常往往是一系列连续的异常,而非界限分明的类别。为了解释CGA结果,有必要将步态异常与临床损伤联系起来,并区分原发性步态异常和代偿策略。CGA并不能告诉我们如何治疗CP患者,但可以提供步态异常的客观识别,并进一步加深对步态异常的理解。有多种治疗方法可用于管理CP患儿的步态异常。一般来说,治疗旨在限制继发性畸形,重建杠杆臂功能并保留肌肉力量。CGA的其他作用是更好地理解治疗对步态异常的影响。引用本文:Armand S, Decoulon G, Bonnefoy-Mazure A. 脑瘫患儿的步态分析。2016;1:448 - 460。DOI: 10.1302/2058 - 5241.1.000052。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a76b/5489760/41050a375c38/eor-1-448-g001.jpg

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