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儿童和青少年腓骨肌萎缩症的足底动态压力模式。

Dynamic plantar pressure patterns in children and adolescents with Charcot-Marie-Tooth disease.

机构信息

Health Science Department, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.

Physical Therapy, Speech and Occupational Therapy Department, School of Medicine, University of São Paulo, São Paulo, Brazil.

出版信息

Gait Posture. 2021 May;86:112-119. doi: 10.1016/j.gaitpost.2021.03.009. Epub 2021 Mar 6.

Abstract

BACKGROUND

The dynamic plantar pressure patterns of children and adolescents with Charcot-Marie-Tooth (CMT) disease and its relationship to musculoskeletal alterations may help to understand the natural history of the disease and improve therapeutic interventions.

RESEARCH QUESTION

The study compared dynamic plantar pressure patterns in children and adolescents with and without CMT. It also tested the associations between isometric muscle strength (IMS), passive range of motion (ROM), foot posture and dynamic plantar pressure patterns in CMT.

METHODS

This cross-sectional study compared children and adolescents (aged 8-18 years) with CMT (n = 40) with a typical group (n = 40). The plantar pressure distribution during gait was recorded, and the contact area (CA), peak pressure (PP), contact time (CT) and pressure-time integral (PTI) in five foot regions (rearfoot, midfoot lateral, midfoot medial, lateral forefoot and medial forefoot) were analysed. The IMS of the dorsiflexors and plantar flexors, passive ROM, and foot posture were also recorded.

RESULTS

PP (medial midfoot and medial forefoot) and PTI (rearfoot, lateral midfoot and medial forefoot) were higher in children with CMT compared with the typical group. The adolescents with CMT presented a less CA (whole foot) and a higher CT (medial midfoot) when compared with typical group. For CMT, in the medial midfoot, plantar flexor IMS associated with PP (β=-11.54, p = 0.01) and PTI (β=-3.38, p = 0.04); supinated foot posture associated with PP (β = 33.89, p = 0.03) and PTI (β = 12.01, p = 0.03).

SIGNIFICANCE

Children with CMT showed clear changes in most of the dynamic plantar pressure variables, while adolescents with CMT showed changes mostly in CA and CT. This information together with the associations established between supinated foot, dorsiflexion ROM and plantar flexions IMS can be useful for guiding rehabilitation professionals in their therapies.

摘要

背景

研究儿童和青少年腓骨肌萎缩症(CMT)的足底压力动态变化模式及其与肌肉骨骼改变的关系,有助于了解疾病的自然病程并改善治疗干预措施。

研究问题

本研究比较了儿童和青少年 CMT 患者与非 CMT 患者的足底压力动态变化模式,并检测了 CMT 患者的等长肌肉力量(IMS)、被动关节活动度(ROM)、足弓形态与足底压力动态变化模式之间的相关性。

方法

本横断面研究比较了 40 名 CMT 患儿和青少年(8-18 岁)与 40 名典型组儿童和青少年。记录行走时的足底压力分布,分析 5 个足部区域(足跟、中足外侧、中足内侧、前足外侧和前足内侧)的接触面积(CA)、峰值压力(PP)、接触时间(CT)和压力时间积分(PTI)。还记录了背屈肌和跖屈肌的 IMS、被动 ROM 和足弓形态。

结果

与典型组相比,CMT 患儿的 PP(中足内侧和前足内侧)和 PTI(足跟、中足外侧和前足内侧)更高。与典型组相比,CMT 青少年的 CA(整个足部)更小,CT(中足内侧)更高。对于 CMT,在中足内侧,跖屈肌 IMS 与 PP(β=-11.54,p=0.01)和 PTI(β=-3.38,p=0.04)相关;旋前足姿势与 PP(β=33.89,p=0.03)和 PTI(β=12.01,p=0.03)相关。

意义

CMT 患儿的大多数足底压力变量均发生明显变化,而 CMT 青少年的 CA 和 CT 变化较大。这些信息以及旋前足、背屈 ROM 和跖屈肌 IMS 之间建立的相关性,可为康复专业人员的治疗提供参考。

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