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髋关节肌肉弹性与脑瘫髋关节迁移指数的关系。

Association Between the Elasticity of Hip Muscles and the Hip Migration Index in Cerebral Palsy.

机构信息

Department of Physical Medicine and Rehabilitation, Baskent University Faculty of Medicine, Istanbul, Turkey.

Department of Radiology, Baskent University Faculty of Medicine, Adana, Turkey.

出版信息

J Ultrasound Med. 2019 Oct;38(10):2667-2672. doi: 10.1002/jum.14969. Epub 2019 Feb 18.

Abstract

OBJECTIVES

Cerebral palsy (CP) increases the risk of hip displacement during childhood. Abnormal hip muscle forces have been proposed as the predisposing factors. In CP, the amount of hip displacement is commonly evaluated by the Reimers hip migration index (MI) on an anteroposterior pelvic radiograph. To the best of our knowledge, the association between the elasticity of hip muscles measured by shear wave elastography and the MI has not been studied yet. Herein, we aimed to analyze the correlation between the elasticity of hip muscles and the MI.

METHODS

Bilateral hips of 25 children with spastic CP were included prospectively in this study. Anteroposterior pelvic radiographs were used to measure the MI. Shear wave elastography was performed to evaluate the elasticity of muscles. The correlation between the MI and the elasticity of hip flexor and adductor muscle groups was assessed. Also, the association between the elasticity of agonist/antagonist muscles was analyzed.

RESULTS

The MI showed fair to good correlations with hip flexors and adductors for both readers (0.71 ≥ r ≥ 0.52). The mean MIs of the patients ± SDs were 22.64% ± 7.79% for reader 1 and 21.55% ± 8.83% for reader 2. The elasticity of agonist/antagonist muscle groups showed little/no to a weak correlation for both readers (0.32 ≥ r ≥ -0.07).

CONCLUSIONS

Although, hip flexor and adductor muscle elasticity showed a correlation with MI, it seems very hard to say that increased elasticity of hip flexor and adductor muscles causes hip dislocation.

摘要

目的

脑瘫(CP)会增加儿童时期髋关节移位的风险。髋关节肌肉力量异常被认为是导致髋关节移位的潜在因素。在 CP 中,髋关节的移位量通常通过前后骨盆 X 线片上的 Reimers 髋关节迁移指数(MI)进行评估。据我们所知,剪切波弹性成像测量的髋关节肌肉弹性与 MI 之间的相关性尚未被研究过。在此,我们旨在分析髋关节肌肉弹性与 MI 之间的相关性。

方法

本前瞻性研究纳入了 25 例痉挛型 CP 患儿的双侧髋关节。采用前后骨盆 X 线片测量 MI。通过剪切波弹性成像评估肌肉弹性。评估 MI 与髋关节屈肌和内收肌群弹性之间的相关性。此外,还分析了协同肌/拮抗肌弹性之间的相关性。

结果

MI 与两位读者的髋关节屈肌和内收肌均具有中等至良好的相关性(0.71≥r≥0.52)。两位读者的患者 MI 平均值±标准差分别为 22.64%±7.79%(读者 1)和 21.55%±8.83%(读者 2)。两位读者的协同肌/拮抗肌弹性之间表现出较小/无至弱的相关性(0.32≥r≥-0.07)。

结论

尽管髋关节屈肌和内收肌弹性与 MI 之间存在相关性,但很难说髋关节屈肌和内收肌弹性的增加会导致髋关节脱位。

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