Pons Roser, Vanezis Athanasios, Skouteli Helen, Papavasiliou Antigoni, Tziomaki Magda, Syrengelas Dimitris, Darras Nikolaos
1 First Department of Pediatrics, Agia Sofia Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece.
2 Gait and Motion Analysis Center, ELEPAP-Rehabilitation for the Disabled, Athens, Greece.
J Child Neurol. 2017 Oct;32(11):936-941. doi: 10.1177/0883073817722451. Epub 2017 Aug 4.
Assessment of upper limb function, kinematic analysis, and dystonia in patients with spastic diplegia cerebral palsy and periventricular leukomalacia. Seven children with spastic diplegia cerebral palsy and 8 controls underwent upper limb kinematics. Movement duration, average and maximum linear velocity, index of curvature, index of dystonia, and target accuracy and stability were analyzed. In the patients with spastic diplegia, Gross Motor Function and Manual Ability Classification Systems were determined, and spasticity and dystonia were rated using the Modified Ashworth and the Burke-Fahn-Marsden Dystonia scales respectively. Children with spastic diplegia demonstrated a tendency toward higher index of dystonia reflecting overflow, higher index of curvature, lower velocities, and poor target accuracy and stability. All patients showed clinical evidence of dystonia in the upper limbs. Dystonia scores correlated with the Manual Ability Classification System (r = 0.86, P = .01) and with the index of dystonia (r = 0.82, P = .02). Children with spastic diplegia cerebral palsy present dystonia in the upper limbs. This is functionally relevant and can be measured with kinematic analysis.
痉挛型双侧瘫脑瘫和脑室周围白质软化症患者上肢功能、运动学分析及肌张力障碍评估。7名痉挛型双侧瘫脑瘫患儿和8名对照者接受了上肢运动学检查。分析了运动持续时间、平均和最大线性速度、曲率指数、肌张力障碍指数以及目标准确性和稳定性。对于痉挛型双侧瘫患者,确定了粗大运动功能和手动能力分类系统,并分别使用改良Ashworth量表和Burke-Fahn-Marsden肌张力障碍量表对痉挛和肌张力障碍进行评分。痉挛型双侧瘫患儿表现出肌张力障碍指数更高(反映溢出)、曲率指数更高、速度更低以及目标准确性和稳定性较差的趋势。所有患者均有上肢肌张力障碍的临床证据。肌张力障碍评分与手动能力分类系统相关(r = 0.86,P = .01),与肌张力障碍指数相关(r = 0.82,P = .02)。痉挛型双侧瘫脑瘫患儿上肢存在肌张力障碍。这在功能上具有相关性,并且可以通过运动学分析进行测量。