Zago Matteo, Sforza Chiarella, Bona Alessia, Cimolin Veronica, Costici Pier Francesco, Condoluci Claudia, Galli Manuela
Department of Electronics, Information and Bioengineering (DEIB), Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milano, Italy; Department of Biomedical Sciences for Health, Università degli Studi di Milano, via Mangiagalli 31, 20133 Milano, Italy.
Department of Biomedical Sciences for Health, Università degli Studi di Milano, via Mangiagalli 31, 20133 Milano, Italy; Institute of Molecular Bioimaging and Physiology, National Research Council, Segrate, Italy.
Clin Biomech (Bristol). 2017 Oct;48:103-109. doi: 10.1016/j.clinbiomech.2017.07.016. Epub 2017 Aug 8.
The relationship between gait features and coordination in children with Cerebral Palsy is not sufficiently analyzed yet. Principal Component Analysis can help in understanding motion patterns decomposing movement into its fundamental components (Principal Movements). This study aims at quantitatively characterizing the functional connections between multi-joint gait patterns in Cerebral Palsy.
65 children with spastic diplegia aged 10.6 (SD 3.7) years participated in standardized gait analysis trials; 31 typically developing adolescents aged 13.6 (4.4) years were also tested. To determine if posture affects gait patterns, patients were split into Crouch and knee Hyperextension group according to knee flexion angle at standing. 3D coordinates of hips, knees, ankles, metatarsal joints, pelvis and shoulders were submitted to Principal Component Analysis.
Four Principal Movements accounted for 99% of global variance; components 1-3 explained major sagittal patterns, components 4-5 referred to movements on frontal plane and component 6 to additional movement refinements. Dimensionality was higher in patients than in controls (p<0.01), and the Crouch group significantly differed from controls in the application of components 1 and 4-6 (p<0.05), while the knee Hyperextension group in components 1-2 and 5 (p<0.05).
Compensatory strategies of children with Cerebral Palsy (interactions between main and secondary movement patterns), were objectively determined. Principal Movements can reduce the effort in interpreting gait reports, providing an immediate and quantitative picture of the connections between movement components.
脑性瘫痪患儿的步态特征与协调性之间的关系尚未得到充分分析。主成分分析有助于理解运动模式，即将运动分解为其基本成分（主要运动）。本研究旨在定量表征脑性瘫痪中多关节步态模式之间的功能联系。
65名年龄为10.6（标准差3.7）岁的痉挛型双瘫患儿参与了标准化步态分析试验；还测试了31名年龄为13.6（4.4）岁的发育正常青少年。为了确定姿势是否影响步态模式，根据站立时的膝关节屈曲角度将患者分为蹲伏组和膝关节过伸组。将髋、膝、踝、跖关节、骨盆和肩部的三维坐标进行主成分分析。
四个主要运动占总体方差的99%；成分1-3解释了主要矢状面模式，成分4-5指的是额平面上的运动，成分6指的是额外的运动细化。患者的维度高于对照组（p<0.01），蹲伏组在成分1和4-6的应用上与对照组有显著差异（p<0.05），而膝关节过伸组在成分1-2和5上与对照组有显著差异（p<0.05）。
客观确定了脑性瘫痪患儿的代偿策略（主要和次要运动模式之间的相互作用）。主要运动可以减少解读步态报告的工作量，提供运动成分之间联系的即时定量情况。
