Joanna Majewska, Magdalena Szczepanik, Katarzyna Bazarnik-Mucha, Daniel Szymczyk, Ewa Lenart-Domka
Institute of Health Sciences, Medical College, University of Rzeszow, 35-959 Rzeszów, Poland.
Children (Basel). 2020 Sep 25;7(10):149. doi: 10.3390/children7100149.
Cerebral palsy (CP) children present complex and heterogeneous motor disorders that cause gait deviations. Clinical gait analysis (CGA) is used to identify, understand and support the management of gait deviations in CP. Children with CP often use ankle-foot orthosis (AFO) to facilitate and optimize their walking ability. The aim of this study was to assess whether the gait deviation index (GDI) and the gait variability index (GVI) results can reflect the changes of spatio-temporal and kinematic gait parameters in spastic hemiplegic CP children wearing AFO.
The study group consisted of 37 CP children with hemiparesis. All had undergone a comprehensive, instrumented gait analysis while walking, both barefoot and with their AFO, during the same CGA session. Kinematic and spatio-temporal data were collected and GVI and GDI gait indexes were calculated.
Significant differences were found between the barefoot condition and the AFO conditions for selected spatio-temporal and kinematic gait parameters. Changes in GVI and GDI were also statistically significant.
The use of AFO in hemiplegic CP children caused a statistically significant improvement in spatio-temporal and kinematic gait parameters. It was found that these changes were also reflected by GVI and GDI. These findings might suggest that gait indices, such as GDI and GVI, as clinical outcome measures, may reflect the effects of specific therapeutic interventions in CP children.
脑性瘫痪（CP）患儿存在复杂且多样的运动障碍，可导致步态异常。临床步态分析（CGA）用于识别、理解并支持对CP患儿步态异常的管理。CP患儿常使用踝足矫形器（AFO）来促进并优化其行走能力。本研究的目的是评估步态偏差指数（GDI）和步态变异性指数（GVI）的结果是否能反映佩戴AFO的痉挛性偏瘫型CP患儿时空及运动学步态参数的变化。
研究组由37例偏瘫型CP患儿组成。所有患儿均在同一次CGA过程中，于行走时分别在赤足和佩戴AFO的情况下接受了全面的、借助仪器的步态分析。收集了运动学和时空数据，并计算了GVI和GDI步态指数。
在选定的时空及运动学步态参数方面，赤足状态与佩戴AFO状态之间存在显著差异。GVI和GDI的变化在统计学上也具有显著性。
偏瘫型CP患儿使用AFO可使时空及运动学步态参数在统计学上得到显著改善。研究发现，这些变化也通过GVI和GDI得以体现。这些结果可能表明，诸如GDI和GVI等步态指数作为临床结局指标，可能反映了针对CP患儿的特定治疗干预的效果。
