Department of Physical Medicine and Rehabilitation, University of Pittsburgh and UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA.
Department of Pediatrics, University of South Carolina and Prisma Health Children's Hospital, Columbia, SC, USA.
Dev Med Child Neurol. 2022 Oct;64(10):1281-1288. doi: 10.1111/dmcn.15225. Epub 2022 Apr 2.
To examine the relationship between quantitative gait measurements and self-reported physical, psychological, cognitive, and social function status in young adults with cerebral palsy (CP).
Seventy-two adults with CP (range 18-48y; median age 23y [interquartile range 21-27y]; 34 males, 38 females), in Gross Motor Function Classification System levels I to IV, who previously underwent an instrumented gait analysis (IGA) at our center as children were recruited. Participants underwent a repeated IGA. National Institutes of Health Patient-Reported Outcomes Information System (PROMIS) instruments including the PROMIS-57, Applied Cognition - General Concerns (Short Form), and Applied Cognition - Executive Function (Short Form) were administered. Data derived from current and prior IGA were compared via non-parametric correlation analysis with PROMIS subscores.
Subscores for anxiety, depression, sleep, and fatigue did not significantly correlate with any IGA data. Walking speed, adjusted for stature, correlated strongly with multiple subscores: physical function (p<0.001, r =0.708); participation in social roles (p=0.007, r =0.319); executive function (p=0.005, r =0.335). Pain interference correlated with longitudinal change in adjusted walking speed (p=0.032, r =-0.259). The Applied Cognition - General Concerns (Short Form) correlated with prior absolute walking speed, but not adjusted values.
This study underscores the importance of walking speed and its association with a variety of functional domains in adults with CP.
Patient-Reported Outcomes Information System measures provide useful clinical data in young adults with cerebral palsy. Temporospatial gait parameters have wide-reaching functional influence in this population. Walking speed is strongly correlated with physical, social, and executive function.
研究年轻脑瘫患者（CP）的定量步态测量值与自我报告的身体、心理、认知和社会功能状态之间的关系。
招募了 72 名年龄在 18-48 岁（中位数年龄 23 岁[四分位距 21-27 岁]；男性 34 名，女性 38 名）、脑瘫粗大运动功能分级系统（GMFCS）I 级至 IV 级的成年 CP 患者。所有患者均曾在本中心进行过仪器步态分析（IGA），参与者再次进行 IGA。并进行了国家卫生研究院患者报告结局信息系统（PROMIS）量表，包括 PROMIS-57、应用认知-一般关注（短表）和应用认知-执行功能（短表）。通过非参数相关分析，将当前和既往 IGA 数据与 PROMIS 子量表得分进行比较。
焦虑、抑郁、睡眠和疲劳的子量表得分与任何 IGA 数据均无显著相关性。调整身高后的行走速度与多个子量表得分显著相关：身体功能（p<0.001，r=0.708）；参与社会角色（p=0.007，r=0.319）；执行功能（p=0.005，r=0.335）。疼痛干扰与调整后的行走速度的纵向变化相关（p=0.032，r=-0.259）。应用认知-一般关注（短表）与既往绝对行走速度相关，但与调整后的值无关。
本研究强调了行走速度及其与 CP 成年患者多种功能领域的关联的重要性。
PROMIS 量表在年轻 CP 患者中提供了有用的临床数据。时空步态参数对该人群具有广泛的功能影响。行走速度与身体、社会和执行功能密切相关。
