KU Leuven, Bruges Campus, Department of Rehabilitation Sciences, Research Group for Neurorehabilitation, Bruges, Belgium.
KU Leuven, Department of Biosystems, Division of Animal and Human Health Engineering, Measure, Model and Manage Bioresponse (M3-BIORES), Leuven, Belgium.
Disabil Rehabil. 2022 Aug;44(17):4794-4805. doi: 10.1080/09638288.2021.1921064. Epub 2021 May 10.
To explore the relation between exercise load, physical activity intensity, and movement disorders during powered wheelchair (PW) mobility in people with severe dyskinetic cerebral palsy (DCP).
Ten participants with DCP, 6-21 years old, users of a head/foot steering system were included. Dystonia and choreoathetosis were assessed using the Dyskinesia Impairment Mobility Scale (DIMS), heart rate (HR) was used to assess the exercise load of the tasks on the participants, and the accelerometry-based activity index (AI) to measure the physical activity intensity and energy expenditure during mobility task performance.
Neck- and distal arm dystonia showed significant correlations with HR (0.64 < < 0.77; 0.009 < < 0.048), whereas neck- and proximal arm choreoathetosis with AI (0.64 < < 0.76, 0.011 < < 0.044). Total-body AI was strongly correlated to the AI of the arms (0.66 < < 0.90, < 0.001 < < 0.038), but not to the AI of the head.
During PW mobility tasks, dystonia is associated to exercise load and choreoathetosis to physical activity intensity and energy expenditure. Findings highlight the difficulties in measuring exercise load and activity intensity in PW users with DCP due to the involuntary hypertonic and/or hyperkinetic hallmark of the movement disorders. Nevertheless, a relaxed surrounding with minimal distractions during PW training may increase learning efficiency. Future studies with a bigger sample size are highly recommended to fully establish the relationship between the variables and to allow generalizability of results.Implications for rehabilitationDystonia is positively related to heart rate during powered mobility, which may be explained by the hypertonic hallmark of dystonia causing an increase in exercise load.Choreoathetosis is positively related to the physical activity index during powered mobility where the hyperkinetic hallmark of choreoathetosis may lead to an increase in physical activity intensity and energy expenditure.Arm overflow movements are the component which contribute the most to total-body activity index, thus, minimizing these movements may lower the overall energy expenditure during powered mobility.Mobility training in a relaxed surrounding with minimal distractions and minimized arm overflow movements may lead to a less-demanding powered wheelchair mobility experience and increased learning efficiency.
探索严重运动障碍性脑瘫（DCP）患者在使用动力轮椅（PW）时运动负荷、身体活动强度与运动障碍之间的关系。
纳入 10 名年龄 6-21 岁、使用头/脚转向系统的 DCP 患者。使用运动障碍残疾移动量表（DIMS）评估患者的肌张力障碍和舞蹈手足徐动症，使用心率（HR）评估任务对患者运动负荷的影响，使用基于加速度计的活动指数（AI）测量移动任务表现期间的身体活动强度和能量消耗。
颈部和远端手臂肌张力障碍与 HR 呈显著相关性（0.64< < 0.77；0.009< < 0.048），而颈部和近端手臂舞蹈手足徐动症与 AI 呈显著相关性（0.64< < 0.76，0.011< < 0.044）。全身 AI 与手臂 AI 呈高度相关性（0.66< < 0.90， < 0.001< < 0.038），但与头部 AI 不相关。
在 PW 移动任务中，肌张力障碍与运动负荷有关，舞蹈手足徐动症与身体活动强度和能量消耗有关。研究结果表明，由于运动障碍的不自主张力过高和/或过高的特征，测量 DCP 患者的运动负荷和活动强度存在困难。然而，在 PW 训练期间，在一个放松的环境中，尽量减少干扰，可能会提高学习效率。建议进行更大样本量的未来研究，以充分建立变量之间的关系，并允许结果具有普遍性。
肌张力障碍与动力移动时的心率呈正相关，这可能是由于肌张力障碍的张力过高特征导致运动负荷增加。舞蹈手足徐动症与动力移动时的身体活动指数呈正相关，这可能是由于舞蹈手足徐动症的多动特征导致身体活动强度和能量消耗增加。手臂溢出运动是总身体活动指数的主要组成部分，因此，减少这些运动可能会降低动力移动时的总能量消耗。在一个放松的环境中，尽量减少干扰并减少手臂溢出运动的移动训练，可能会使动力轮椅移动体验不那么费力，并提高学习效率。
