Department of Biomedical Engineering, National Taiwan University, Taipei, Taiwan, R.O.C.
Department of Orthopedics, China Medical University Hospital, Taichung, Taiwan, R.O.C.
J Orthop Res. 2020 Sep;38(9):2006-2014. doi: 10.1002/jor.24635. Epub 2020 Mar 3.
Deviations are often identified at individual joints in the gait analysis of patients with cerebral palsy. Previous gait studies on hemiplegic cerebral palsy (HCP) have focused mainly on deviations of the affected side. The current study aimed to quantify and compare the joint and leg stiffness, the contributions of skeletal and muscular components, and the associated joint angles and moments of the affected and nonaffected lower limbs during level walking in children with spastic HCP. A total of 12 children with spastic HCP and 12 healthy controls walked at a self-selected speed in a gait laboratory while their kinematic and forceplate data were measured and analyzed during loading response, midstance, terminal stance, and preswing. The altered joint kinematics and kinetics in the nonaffected limb in the HCP group appeared to be mainly a compensatory strategy to minimize the bilateral asymmetry in leg stiffness during the double-limb support phase and joint stiffness during the entire stance phase. The current results suggest that therapeutic planning and decision-making for children with HCP should consider not only the mechanics of the affected side but also the control of the nonaffected side.
脑瘫患者步态分析中常可发现个别关节的偏差。既往偏瘫脑瘫（HCP）的步态研究主要集中在患侧的偏差。本研究旨在定量和比较痉挛型 HCP 儿童在步态实验室中以自身选择的速度行走时，在负荷反应、中间站立、终末站立和预摆期间，受累和未受累下肢的关节和腿部僵硬、骨骼和肌肉成分的贡献以及相关关节角度和力矩。共有 12 名痉挛型 HCP 儿童和 12 名健康对照组在步态实验室中以自身选择的速度行走，同时测量和分析他们的运动学和测力板数据。HCP 组中未受累肢体的关节运动学和动力学变化似乎主要是一种补偿策略，旨在最小化双足支撑阶段腿部僵硬的双侧不对称性和整个站立阶段的关节僵硬。目前的结果表明，HCP 儿童的治疗计划和决策不仅应考虑受累侧的力学，还应考虑未受累侧的控制。
