Yu Yawen, Lauer Richard T, Tucker Carole A, Thompson Elizabeth D, Keshner Emily A
a Department of Physical Therapy , Temple University , Philadelphia , PA, USA.
b Shriners Hospitals for Children - Philadelphia , Philadelphia , PA, USA.
Dev Neurorehabil. 2018 Nov;21(8):531-541. doi: 10.1080/17518423.2018.1424265. Epub 2018 Jan 17.
The current study aimed to explore the impact of visual dependence on sensorimotor coupling of postural sway and visual motion in adults and teens with spastic cerebral palsy (CP). We hypothesized that individuals with CP would exhibit greater magnitudes of sway than healthy individuals, and the presence of visual dependence (VD) would produce instability in the direction of visual motion. Participants stood in a virtual environment in which the visual scene remained static or continuously rotated 30 degree/second in pitch-up or pitch-down. Increased center of pressure and center of mass responses were observed in the direction of visual scene motion in those with CP. Those with VD exhibited reduced frequency responses in anterior-posterior direction than those who were visually independent. VD suggests deficient sensorimotor integration that could contribute to postural instability and reduced motor function. Individuals with CP who are visually dependent may benefit from more sensory focused rehabilitation strategies.
AP, anterior-posterior; CP, cerebral palsy; COM, center of mass; COP, center of pressure; MDF, median frequency; ML, mediolateral; PD, pitch down (nose down) rotation; PU, pitch up (nose up) rotation; RFT, rod and frame test; RMS, root mean square; SLP, slope of the fitted line; TD, typical development; VD, visual dependence; VI, visual independence; VOR, vestibulo-ocular reflex; VPI, visual perceptual impairment.
本研究旨在探讨视觉依赖对成人和青少年痉挛型脑瘫(CP)患者姿势摆动和视觉运动的感觉运动耦合的影响。我们假设,与健康个体相比,脑瘫患者会表现出更大幅度的摆动,并且视觉依赖(VD)的存在会在视觉运动方向上产生不稳定性。参与者站在一个虚拟环境中,其中视觉场景保持静止或每秒30度向上或向下俯仰连续旋转。在脑瘫患者中,观察到压力中心和质心反应在视觉场景运动方向上增加。与视觉独立的患者相比,有视觉依赖的患者在前后方向上的频率反应降低。视觉依赖表明感觉运动整合不足,这可能导致姿势不稳定和运动功能下降。有视觉依赖的脑瘫患者可能会从更多以感觉为重点的康复策略中受益。
AP,前后;CP,脑瘫;COM,质心;COP,压力中心;MDF,中位数频率;ML,内外侧;PD,向下俯仰(鼻尖向下)旋转;PU,向上俯仰(鼻尖向上)旋转;RFT,杆框试验;RMS,均方根;SLP,拟合线斜率;TD,正常发育;VD,视觉依赖;VI,视觉独立;VOR,前庭眼反射;VPI,视觉感知障碍。