Spinal Cord Injury Research Laboratory, Crawford Research Institute, Shepherd Center, Atlanta, GA, USA.
Program in Biomechanics and Movement Science, University of Delaware, Newark, DE, USA.
J Pediatr Rehabil Med. 2021;14(2):247-255. doi: 10.3233/PRM-190643.
To investigate foot and ankle somatosensory function in children with cerebral palsy (CP).
Ten children with spastic diplegia (age 15 ± 5 y; GMFCS I-III) and 11 typically developing (TD) peers (age 15 ± 10 y) participated in the study. Light touch pressure and two-point discrimination were assessed on the plantar side of the foot by using a monofilament kit and an aesthesiometer, respectively. The duration of vibration sensation at the first metatarsal head and medial malleolus was tested by a 128 Hz tuning fork. Joint position sense and kinesthesia in the ankle joint were also assessed.
Children with CP demonstrated significantly higher light touch pressure and two-point discrimination thresholds compared to their TD peers. Individuals with CP perceived the vibration stimulus for a longer period compared to the TD participants. Finally, the CP group demonstrated significant impairments in joint position sense but not in kinesthesia of the ankle joints.
These findings suggest that children with CP have foot and ankle tactile and proprioceptive deficits. Assessment of lower extremity somatosensory function should be included in clinical practice as it can guide clinicians in designing more effective treatment protocols to improve functional performance in CP.
研究脑瘫(CP)儿童的足部和踝关节躯体感觉功能。
本研究纳入 10 名痉挛型双瘫患儿(年龄 15 ± 5 岁;GMFCS I-III 级)和 11 名正常发育(TD)儿童(年龄 15 ± 10 岁)。使用单丝套件评估足底的轻触压力和两点辨别觉,使用触觉计评估第一跖骨头和内踝的振动感觉持续时间。还评估了踝关节的关节位置觉和运动觉。
与 TD 组相比,CP 组的轻触压力和两点辨别觉阈值显著更高。与 TD 参与者相比,CP 个体感知到的振动刺激时间更长。最后,CP 组在踝关节的关节位置觉上存在显著的障碍,但在运动觉上没有。
这些发现表明 CP 儿童存在足部和踝关节的触觉和本体感觉缺陷。下肢躯体感觉功能的评估应纳入临床实践,因为它可以指导临床医生制定更有效的治疗方案,以提高 CP 患者的功能表现。