Kusumoto Yasuaki, Tsuchiya Junko, Watanabe Yoshiteru, Umeda Masaru, Matsuda Tadamitsu, Takaki Kenji, Nitta Osamu
Department of Physical Therapy, Division of Health Science, Tokyo University of Technology: 5-23-22 Nishikamata, Ohta-ku, Tokyo 144-8635, Japan.
Department of Physical Therapy, Faculty of Health Science, Juntendo University, Japan.
J Phys Ther Sci. 2020 Jan;32(1):23-26. doi: 10.1589/jpts.32.23. Epub 2020 Jan 22.
[Purpose] This study examined characteristics of dynamic standing balance, with an without an insole, in patients with spastic diplegia cerebral palsy (CP). [Participants and Methods] This cross-sectional study used a crossover design. Eleven patients with spastic diplegia CP and gross motor levels between I and III with spastic diplegia CP (according to the Gross Motor Function Classification System expanded and revised version) were randomly allocated to either the barefoot or insole groups. The Index of postural stability (IPS) was evaluated while each patient was barefoot and while wearing insoles. The Pediatric Evaluation of Disability Inventory (PEDI) was used to measure functional self-care and mobility domains. [Results] While wearing the insoles, the center movement distance between right and left positions was significantly higher. While barefoot, IPS and area of postural sway correlated with the PEDI subscales for mobility and self-care. [Conclusion] Insoles promote standing balance and dynamic balance to move the center of pressure within the base of support. Such improvements may enhance activities of daily living in patients with spastic diplegia CP.
[目的] 本研究探讨了痉挛型双瘫脑瘫(CP)患者在有无鞋垫情况下的动态站立平衡特征。[参与者与方法] 本横断面研究采用交叉设计。11例痉挛型双瘫CP且粗大运动水平在I至III级(根据粗大运动功能分类系统扩展和修订版)的患者被随机分配至赤脚组或鞋垫组。在每位患者赤脚和穿着鞋垫时评估姿势稳定性指数(IPS)。使用儿童残疾评定量表(PEDI)测量功能自理和活动领域。[结果] 穿着鞋垫时,左右位置之间的中心移动距离显著更高。赤脚时,IPS和姿势摆动面积与PEDI活动和自理分量表相关。[结论] 鞋垫可促进站立平衡和动态平衡,使压力中心在支撑面内移动。这种改善可能会增强痉挛型双瘫CP患者的日常生活活动能力。