预测青少年脑瘫患者髋关节发育不良，以优化预防和康复。一项纵向描述性研究。
Predicting Hip Dysplasia in Teenagers with Cerebral Palsy in order to Optimize Prevention and Rehabilitation. A Longitudinal Descriptive Study.
机构信息
Nicole Wertheim College of Nursing and Health Sciences, Department of Physical Therapy, Florida International University, Miami, FL, USA.
PredictMed Lab, EEAP H. Germain, Children Hospital, Nice, France.
出版信息
Dev Neurorehabil. 2021 Apr;24(3):166-172. doi: 10.1080/17518423.2020.1819459. Epub 2020 Oct 15.
OBJECTIVE
To develop a predictive model of neuromuscular hip dysplasia (NHD) in teenagers with cerebral palsy (CP) to optimize rehabilitation.
DESIGN
A longitudinal, multicenter, double-blinded, descriptive study of one hundred and two teenagers with CP (age 16.5 ± 1.2 years, range 12-18 years). Data on etiology, diagnosis, spasticity, epilepsy, clinical history, and functional assessments were collected from 2005 to 2017 and entered in the prediction model "PredictMed."
RESULTS
Poor walking abilities [ < .001; Odd Ratio (OR) Infinity], scoliosis (p 0.01; OR 3.22), trunk muscles' tone disorder (p 0.002; OR 4.81), spasticity (p 0.006; OR 6.6), poor motor function (p 0.02; OR 5.5), and epilepsy (p 0.03; OR 2.6) were predictors of NHD development. The accuracy of the model was 77%.
CONCLUSION
Trunk muscles' tone disorder, severe scoliosis, epilepsy, and spasticity were predictors of NHD in teenagers with CP. Based on the results we have developed appropriate preventative rehabilitation interventions.
目的
为青少年脑瘫患者建立神经肌肉性髋关节发育不良（NHD）的预测模型，以优化康复。
设计
一项对 102 名青少年脑瘫患者（年龄 16.5 ± 1.2 岁，范围 12-18 岁）进行的纵向、多中心、双盲、描述性研究。2005 年至 2017 年收集了病因、诊断、痉挛、癫痫、临床病史和功能评估等数据，并输入预测模型“PredictMed”。
结果
行走能力差[<.001；无限比值比（OR）]、脊柱侧凸（p 0.01；OR 3.22）、躯干肌肉张力障碍（p 0.002；OR 4.81）、痉挛（p 0.006；OR 6.6）、运动功能差（p 0.02；OR 5.5）和癫痫（p 0.03；OR 2.6）是 NHD 发展的预测因素。该模型的准确率为 77%。
结论
躯干肌肉张力障碍、严重脊柱侧凸、癫痫和痉挛是青少年脑瘫患者 NHD 的预测因素。根据研究结果，我们制定了相应的预防康复干预措施。
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