Ancillao Andrea, van der Krogt Marjolein M, Buizer Annemieke I, Witbreuk Melinda M, Cappa Paolo, Harlaar Jaap
Dept. of Mechanical and Aerospace Engineering, "Sapienza" University of Rome, Via Eudossiana 18, 00184 Roma, Italy; Dept. of Rehabilitation Medicine, VU University Medical Center, Amsterdam Movement Sciences, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
Dept. of Rehabilitation Medicine, VU University Medical Center, Amsterdam Movement Sciences, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
Hum Mov Sci. 2017 Oct;55:145-155. doi: 10.1016/j.humov.2017.08.005. Epub 2017 Aug 19.
Gait analysis is used for the assessment of walking ability of children with cerebral palsy (CP), to inform clinical decision making and to quantify changes after treatment. To simplify gait analysis interpretation and to quantify deviations from normality, some quantitative synthetic descriptors were developed over the years, such as the Movement Analysis Profile (MAP) and the Linear Fit Method (LFM), but their interpretation is not always straightforward. The aims of this work were to: (i) study gait changes, by means of synthetic descriptors, in children with CP that underwent Single Event Multilevel Surgery; (ii) compare the MAP and the LFM on these patients; (iii) design a new index that may overcome the limitations of the previous methods, i.e. the lack of information about the direction of deviation or its source. Gait analysis exams of 10 children with CP, pre- and post-surgery, were collected and MAP and LFM were computed. A new index was designed asa modified version of the MAP by separating out changes in offset (named OC-MAP). MAP documented an improvement in the gait pattern after surgery. The highest effect was observed for the knee flexion/extension angle. However, a worsening was observed as an increase in anterior pelvic tilt. An important source of gait deviation was recognized in the offset between observed tracks and reference. OC-MAP allowed the assessment of the offset component versus the shape component of deviation. LFM provided results similar to OC-MAP offset analysis but could not be considered reliable due to intrinsic limitations. As offset in gait features played an important role in gait deviation, OC-MAP synthetic analysis was proposed as a novel approach to a meaningful parameterisation of global deviations in gait patterns of subjects with CP and gait changes after treatment.
步态分析用于评估脑瘫（CP）患儿的行走能力，为临床决策提供依据，并量化治疗后的变化。多年来，为了简化步态分析的解释并量化与正常情况的偏差，人们开发了一些定量综合描述符，如运动分析剖面图（MAP）和线性拟合方法（LFM），但其解释并不总是直观明了。这项工作的目的是：（i）通过综合描述符研究接受单事件多级手术的CP患儿的步态变化；（ii）比较这些患者的MAP和LFM；（iii）设计一种新的指标，以克服先前方法的局限性，即缺乏关于偏差方向或其来源的信息。收集了10名CP患儿手术前后的步态分析检查结果，并计算了MAP和LFM。通过分离偏移变化（命名为OC-MAP），设计了一种新的指标作为MAP的改进版本。MAP记录了手术后步态模式的改善。观察到膝关节屈伸角度的效果最为显著。然而，随着骨盆前倾增加，观察到了恶化情况。在观察轨迹与参考轨迹之间的偏移中发现了步态偏差的一个重要来源。OC-MAP允许评估偏差的偏移分量与形状分量。LFM提供了与OC-MAP偏移分析相似的结果，但由于其内在局限性，不能被认为是可靠的。由于步态特征中的偏移在步态偏差中起重要作用，因此提出OC-MAP综合分析作为一种新的方法，用于对CP患者步态模式中的整体偏差和治疗后的步态变化进行有意义的参数化。
