Choi Ja Young, Park Eun Sook, Park Dongho, Rha Dong-Wook
Department of Physical Medicine & Rehabilitation, Eulji University Hospital, Eulji University College of Medicine, Daejeon, Republic of Korea.
Department of Rehabilitation Medicine, Severance Hospital, Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Gait Posture. 2018 Jul;64:255-259. doi: 10.1016/j.gaitpost.2018.06.163. Epub 2018 Jun 25.
Previous researchers reported that popliteal angle did not correlate well with knee angle during gait in individuals with spastic cerebral palsy (CP).
To determine if hamstring spasticity, as measured by Modified Tardieu Scale (MTS) at rest, is associated with knee flexion angle at initial contact and midstance during gait.
Thirty ambulatory children (mean age 8.7 ± 2.4 years) diagnosed with spastic CP participated. The hamstrings' spasticity was assessed in the supine position with the MTS, measuring R1 (muscle reaction to passive fast stretch), R2 (passive range of motion), and R2-R1 (dynamic component of spasticity). We conducted 3-dimensional computerized gait analysis and calculated semimembranosus muscle-tendon length and lengthening velocity during gait using musculoskeletal modeling and inverse kinematic analysis by OpenSim. Pearson correlation coefficients were calculated to estimate the association of MTS with biomechanical parameters during gait.
Knee flexion angle at initial contact and maximal knee extension angle during stance phase significantly positively correlated with both R1 and ㅣR2 - R1ㅣ of MTS, but not with R2 angle. The length of semimembranosus at initial contact, end of swing, and minimal length during stance phase were strongly negatively associated with R1, rather than R2 or ㅣR2 - R1ㅣ angles.
The R1 angle of MTS (muscle reaction to passive fast stretch) is more relevant correlate of knee flexion angle during gait than the R2 (passive range of motion).
先前的研究人员报告称，在痉挛型脑性瘫痪（CP）患者的步态中，腘角与膝关节角度的相关性不佳。
确定静息时通过改良Tardieu量表（MTS）测量的腘绳肌痉挛是否与步态中初始接触和支撑中期的膝关节屈曲角度相关。
30名被诊断为痉挛型CP的门诊儿童（平均年龄8.7±2.4岁）参与了研究。在仰卧位用MTS评估腘绳肌痉挛，测量R1（肌肉对被动快速拉伸的反应）、R2（被动运动范围）和R2-R1（痉挛的动态成分）。我们进行了三维计算机化步态分析，并使用OpenSim通过肌肉骨骼建模和逆运动学分析计算了步态期间半膜肌肌腱长度和延长速度。计算Pearson相关系数以估计MTS与步态期间生物力学参数的关联。
初始接触时的膝关节屈曲角度和站立期最大膝关节伸展角度与MTS的R1和|R2 - R1|均显著正相关，但与R2角度无关。初始接触、摆动末期和站立期最小长度时的半膜肌长度与R1强烈负相关，而不是与R2或|R2 - R1|角度相关。
与R2（被动运动范围）相比，MTS的R1角度（肌肉对被动快速拉伸的反应）与步态期间膝关节屈曲角度的相关性更强。
