Neurology Department, The Royal Children's Hospital, Parkville, Victoria, Australia.
Physiotherapy Department, The University of Melbourne, Parkville, Victoria, Australia.
Arch Dis Child. 2019 Jun;104(6):535-540. doi: 10.1136/archdischild-2018-314890. Epub 2018 Aug 13.
To prospectively study falls in children and adolescents with Charcot-Marie-Tooth disease (CMT).
Prospective cohort study.
Neuromuscular outpatient clinic of a tertiary paediatric hospital.
Sixty children and adolescents ('children') aged 4-18 years, 30 with CMT and 30 typically developing (TD).
Falls rate over 6 months and falls characteristics questionnaire.
Twenty-two children with CMT reported falling at least once in 6 months compared with eight TD children (CMT 2819 (0-1915), TD 31 (0-6) total falls (range)). Detailed falls characteristics were collected from 242 individual falls (CMT 216, TD 26). Injurious falls were reported by 19 children with CMT (74 falls) compared with 2 TD children (3 falls), with cuts, grazes and bruising most common. No fractures were sustained and no child required hospitalisation. However, 12 injuries from falls in children with CMT required management by a healthcare provider, versus none in TD children. Tripping was the most common mechanism of falls in both groups. Age was the strongest predictor of falls (ρ=-0.53, p=0.006) with all children (CMT and TD) aged <7 years falling. Balance was the strongest impairment-related predictor of falls (ρ=-0.47, p=0.02). The conservative estimate of risk of falls in children and adolescents with CMT was 33 times higher than their TD peers (incidence rate ratio=32.8, 95% CI 10.2 to 106.0).
Children and adolescents with CMT fall more often than TD peers and sustain more injuries when they fall.
前瞻性研究腓骨肌萎缩症（CMT）患儿和青少年的跌倒情况。
前瞻性队列研究。
一家三级儿童医院的神经肌肉门诊。
60 名 4-18 岁的儿童和青少年（“患儿”），其中 30 名患有 CMT，30 名发育正常（TD）。
6 个月内的跌倒率和跌倒特征问卷。
22 名 CMT 患儿报告在 6 个月内至少跌倒过一次，而 TD 患儿为 8 名（CMT 2819（0-1915），TD 31（0-6）总跌倒数（范围））。从 242 次跌倒中详细收集了跌倒特征（CMT 216 次，TD 26 次）。19 名 CMT 患儿（74 次跌倒）报告了受伤性跌倒，而 2 名 TD 患儿（3 次跌倒）报告了受伤性跌倒，最常见的是割伤、擦伤和瘀伤。没有发生骨折，也没有患儿需要住院治疗。然而，12 名 CMT 患儿跌倒受伤需要医疗保健提供者的治疗，而 TD 患儿没有。绊倒是两组中最常见的跌倒机制。年龄是跌倒的最强预测因素（ρ=-0.53，p=0.006），所有年龄<7 岁的患儿都有跌倒。平衡是跌倒最相关的损伤预测因素（ρ=-0.47，p=0.02）。CMT 患儿和青少年跌倒的风险保守估计比 TD 同龄人高 33 倍（发病率比=32.8，95%CI 10.2 至 106.0）。
CMT 患儿和青少年比 TD 同龄人更容易跌倒，跌倒时受伤更严重。
