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下肢横向运动学偏差与单侧脑瘫儿童步态表现的关系:描述性分析。

Relationship Between Transverse-plane Kinematic Deviations of Lower Limbs and Gait Performance in Children with Unilateral Cerebral Palsy: A Descriptive Analysis.

机构信息

Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt; Department of Physical Therapy and Health Rehabilitation, Collage of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia.

出版信息

Gait Posture. 2020 Jun;79:224-228. doi: 10.1016/j.gaitpost.2020.05.003. Epub 2020 May 11.

DOI:10.1016/j.gaitpost.2020.05.003
PMID:32442898
Abstract

BACKGROUND

Transverse-plane kinematic deviations of lower limbs are common in children with unilateral cerebral palsy (UCP), often with detrimental consequences for gait.

RESEARCH QUESTION

To identify the most important factor among rotational anomalies of lower limbs for gait in children with UCP.

METHODS

In a descriptive observational study, 42 children with UCP (age; 5-8 years) who had the ability of independent walking were included. Comprehensive gait analysis was performed and included assessment of the transverse-plane kinematic deviations of the lower limbs [pelvis, hip, and ankle rotation angles, and foot progression (FP) angle], and spatial-temporal gait features [velocity, step length (SL), single-limb support time (SLSt), temporal gait-symmetry index (T-GSI), and spatial gait-symmetry index (S-GSI)].

RESULTS AND SIGNIFICANCE

The regression analysis indicated that hip rotation was the key determinant of gait velocity (R = 0.75, P < .001) and S-GSI (R = 0.24, P = .001). The FP angle was the most important factor for T-GSI (R = 0.22, P = .002). The ankle rotation explained in part the variance in T-GSI (R = 0.10, P = .001).

CONCLUSION

Gait velocity and spatial gait-symmetry are primarily affected by hip rotation anomalies. The temporal gait-symmetry is generally associated with the FP angle deviation and partly with ankle rotation deviation.

摘要

背景

下肢横向平面运动学偏差在单侧脑瘫(UCP)儿童中很常见,常对步态产生不利影响。

研究问题

确定 UCP 儿童下肢旋转异常中对步态最重要的因素。

方法

在一项描述性观察研究中,纳入了 42 名有独立行走能力的 UCP 儿童(年龄为 5-8 岁)。进行全面步态分析,包括下肢横向平面运动学偏差评估[骨盆、髋关节和踝关节旋转角度以及足前进(FP)角度]和时空步态特征[速度、步长(SL)、单肢支撑时间(SLSt)、时间步态对称性指数(T-GSI)和空间步态对称性指数(S-GSI)]。

结果和意义

回归分析表明髋关节旋转是步态速度(R = 0.75,P <.001)和 S-GSI(R = 0.24,P =.001)的关键决定因素。FP 角度是 T-GSI 的最重要因素(R = 0.22,P =.002)。踝关节旋转部分解释了 T-GSI 的方差(R = 0.10,P =.001)。

结论

步态速度和空间步态对称性主要受髋关节旋转异常的影响。时间步态对称性通常与 FP 角度偏差有关,部分与踝关节旋转偏差有关。

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