Univ Lyon, UJM Saint-Etienne, Laboratoire Interuniversitaire de Biologie de la Motricité, EA 7424, F-42023 Saint-Etienne, France; Department of Pediatrics Physical Medicine and Rehabilitation, University Hospital of Saint-Etienne, Faculty of Medicine, France.
Univ Lyon, UJM Saint-Etienne, Laboratoire Interuniversitaire de Biologie de la Motricité, EA 7424, F-42023 Saint-Etienne, France; Department of Pediatrics Physical Medicine and Rehabilitation, University Hospital of Saint-Etienne, Faculty of Medicine, France.
J Electromyogr Kinesiol. 2019 Dec;49:102353. doi: 10.1016/j.jelekin.2019.102353. Epub 2019 Aug 23.
Children with cerebral palsy (CP) present increased passive ankle joint stiffness, measured as the slope of the torque-angle curve relationship. However, large discrepancies in results exist among studies, likely because of various methodologies used. The purpose of this study was to determine the influence of different calculation methods on the outcomes and their inter-session reliability in children with unilateral CP (UCP). Thirteen children (mean age: 9.8 years) with spastic UCP underwent passive ankle mobilization at 2°/s on both legs using a dynamometer, on two occasions separated by one week. Passive ankle joint stiffness was calculated as the slope of the torque-angle curve using linear regression on three different relative ranges of torque (i.e. 30%-100%, 20-80% and 50-90% of maximal torque for method 1, 2 and 3, respectively) for both the paretic and non-paretic legs. Inter-session reliability was significantly lower on paretic leg (mean CV = 13.8%, ICC = 0.62) when compared to non-paretic leg (mean CV = 6%, ICC = 0.85), and method 3 presented lower reliability outcomes (mean CV = 11.7%, ICC = 0.75) than methods 1 (mean CV = 7.5%, ICC = 0.78) and 2 (mean CV = 6.6%, ICC = 0.79). Paretic values (0.24 Nm/°) were not different from the non-paretic leg (0.25 Nm/°), although significantly higher when considering the same angular sector (0.18 Nm/°). Passive ankle joint stiffness measurement can be reliably performed in children with UCP using method 1 and 2 while method 3 should be avoided. The non-paretic leg may be used for comparison with the paretic leg when taking into account differences in maximal dorsiflexion angle between legs. ClinicalTrials.gov Identifier: NCT02960932.
患有脑瘫（CP）的儿童表现出增加的被动踝关节僵硬，其测量方法是扭矩-角度曲线关系的斜率。然而，由于使用了各种不同的方法，研究结果之间存在很大的差异。本研究的目的是确定不同计算方法对单侧脑瘫（UCP）儿童结果的影响及其在不同时间段的可靠性。13 名痉挛型 UCP 儿童（平均年龄：9.8 岁）在两周内两次使用测力计以 2°/s 的速度被动踝关节活动，在双侧腿上进行。使用线性回归在三个不同的扭矩相对范围（即 30%-100%、20-80%和 50-90%最大扭矩用于方法 1、2 和 3）计算被动踝关节刚度，分别为患侧和非患侧腿。与非患侧腿（均方变异系数 CV=6%，组内相关系数 ICC=0.85）相比，患侧腿的组内可靠性明显较低（均方变异系数 CV=13.8%，组内相关系数 ICC=0.62），而方法 3 的可靠性结果较低（均方变异系数 CV=11.7%，组内相关系数 ICC=0.75），低于方法 1（均方变异系数 CV=7.5%，组内相关系数 ICC=0.78）和 2（均方变异系数 CV=6.6%，组内相关系数 ICC=0.79）。患侧的数值（0.24 Nm/°）与非患侧的数值（0.25 Nm/°）没有差异，尽管考虑到相同的角度范围时，患侧的数值（0.18 Nm/°）明显更高。使用方法 1 和 2 可以可靠地测量 UCP 儿童的被动踝关节刚度，而应避免使用方法 3。当考虑双腿最大背屈角度的差异时，可以将非患侧腿用于与患侧腿进行比较。ClinicalTrials.gov 标识符：NCT02960932。
