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运动障碍型脑性瘫痪中痉挛状态及被动活动范围偏差与肌张力障碍、舞蹈徐动症及功能分类系统的临床表现

Clinical Presentation of Spasticity and Passive Range of Motion Deviations in Dyskinetic Cerebral Palsy in Relation to Dystonia, Choreoathetosis, and Functional Classification Systems.

作者信息

Bekteshi Saranda, Vanmechelen Inti, Konings Marco, Ortibus Els, Feys Hilde, Monbaliu Elegast

机构信息

Research Group for Neurorehabilitation, KU Leuven, Bruges, Belgium.

KU Leuven, Leuven, Belgium.

出版信息

Dev Neurorehabil. 2021 Apr;24(3):205-213. doi: 10.1080/17518423.2020.1858457. Epub 2020 Dec 23.

Abstract

: To map the presence, severity, and distribution of spasticity and passive range of motion (pROM) deviations in dyskinetic cerebral palsy (DCP), and to explore their relation with dystonia, choreoathetosis, and functional abilities.: This cross-sectional study included 53 participants with DCP. Spasticity was assessed with the Modified Ashworth Scale, limited- and increased pROM (hypermobility) with a goniometer, dystonia and choreoathetosis with the Dyskinesia Impairment Scale, gross motor and manual abilities with corresponding functional classification systems.: Spasticity and limited pROM were correlated with dystonia of the upper limbs (0.41< r<0.47, <0.001 <  < .002) and lower limbs (0.31< r<0.41, 0.002 <  < .025), and both functional systems of gross motor (0.32< r<0.51, <0.001 <  < .018) and fine manual abilities (0.34< r<0.44, 0.001 <  < .014). Hypermobility is correlated only with choreoathetosis of the lower limbs (0.44, = .001).: Coexisting spasticity and pROM deviations in DCP are functionally limiting and should be addressed accordingly. Hypermobility may lead to an increased luxation risk.

摘要

为明确运动障碍型脑性瘫痪(DCP)中痉挛的存在情况、严重程度及分布,以及被动活动范围(pROM)偏差,并探讨它们与肌张力障碍、舞蹈徐动症及功能能力的关系。:这项横断面研究纳入了53名DCP患者。采用改良Ashworth量表评估痉挛,用角度计评估pROM受限和增加(活动过度),用运动障碍损害量表评估肌张力障碍和舞蹈徐动症,用相应的功能分类系统评估粗大运动和手部能力。:痉挛和pROM受限与上肢肌张力障碍(0.41 < r < 0.47,<0.001 < <.002)和下肢肌张力障碍(0.31 < r < 0.41,0.002 < <.025)相关,且与粗大运动(0.32 < r < 0.51,<0.001 < <.018)和精细手部能力(0.34 < r < 0.44,0.001 < <.014)的功能系统均相关。活动过度仅与下肢舞蹈徐动症相关(0.44,= .001)。:DCP中并存的痉挛和pROM偏差在功能上具有限制作用,应予以相应处理。活动过度可能会增加脱位风险。

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