脑瘫患者与蹲姿步态相关的步态分析指标、功能健康状况和日常活动水平之间的关联。

The association between gait analysis measures associated with crouch gait, functional health status and daily activity levels in cerebral palsy.

机构信息

Gait Analysis Laboratory, Central Remedial Clinic, Dublin, Ireland.

School of Physiotherapy, Royal College of Surgeons in Ireland, Dublin, Ireland.

出版信息

J Pediatr Rehabil Med. 2021;14(2):227-235. doi: 10.3233/PRM-200676.

DOI:10.3233/PRM-200676

PMID:33896854

Abstract

PURPOSE

The aim of this study was to examine the relationship between gait analysis measures associated with crouch gait, functional health status and daily activity in ambulant cerebral palsy (CP).

METHODS

Three-dimensional gait analysis was carried out on 35 ambulant participants with bilateral CP crouch gait (knee flexion at mid-stance (KFMS) ⩾ 190). KFMS, knee-flexion at initial contact, gait speed and step-lengths were extracted for analysis. Steps/day and sedentary time/day were assessed using an ActivPAL accelerometer. Functional health status was assessed using the five relevant domains of the Pediatric Outcomes Data Collection Instrument (PODCI) questionnaire. Associations between variables were assessed with correlation coefficients and multivariable linear regression.

RESULTS

There were no significant correlations between KFMS and PODCI domains (ρ=-0.008-0.110) or daily activity (ρ=-0.297-0.237) variables. In contrast, multivariable analysis found that step-length was independently associated with the Sports and Physical Function (p= 0.030), Transfers and Basic Mobility (p= 0.041) and Global Function (< 0.001) domains of the PODCI assessment. Gait speed was independently associated with mean steps/day (p< 0.001).

CONCLUSIONS

Step length and gait speed are more strongly associated with functional health status and daily activity than knee flexion during stance in children and adolescents with CP crouch gait.

摘要

目的

本研究旨在探讨与蹲姿步态相关的步态分析指标与脑瘫患儿（CP）的功能健康状况和日常活动之间的关系。

方法

对 35 名双侧 CP 蹲姿步态（膝关节在中间位时的屈曲度（KFMS）≥190°）的可独立步行患者进行三维步态分析。提取 KFMS、初始接触时膝关节屈曲度、步态速度和步长进行分析。使用 ActivPAL 加速度计评估每日步数和久坐时间。采用儿科结局数据采集工具（PODCI）问卷的 5 个相关领域评估功能健康状况。使用相关系数和多变量线性回归评估变量之间的相关性。

结果

KFMS 与 PODCI 各领域（ρ=-0.008-0.110）或日常活动（ρ=-0.297-0.237）变量之间无显著相关性。相反，多变量分析发现步长与 PODCI 评估的运动和身体功能（p=0.030）、转移和基本移动性（p=0.041）以及整体功能（p<0.001）领域独立相关。步态速度与平均每日步数（p<0.001）独立相关。