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脑瘫患儿与非脑瘫患儿步态中关节功率与功的分析

Analysis of Joint Power and Work During Gait in Children With and Without Cerebral Palsy.

作者信息

Hazra Priyam, Gibbs Sheila, Arnold Graham, Nasir Sadiq, Wang Weijie

机构信息

Institute of Motion Analysis and Research (IMAR), Department of Orthopaedic and Trauma Surgery, Ninewells Hospital and Medical School, University of Dundee, Dundee, DD1 9SY UK.

出版信息

Indian J Orthop. 2022 Jul 14;56(9):1647-1656. doi: 10.1007/s43465-022-00691-8. eCollection 2022 Sep.

Abstract

PURPOSE

To compare joint work in the lower limb joints during different sub-phases of the gait cycle between Cerebral Palsy (CP) and healthy children.

METHODS

Eighteen CP and 20 healthy children's gait data were collected. The CP group included orthoses, intra-muscular injection of botulinum toxin and surgery groups. A motion capture system was used to collect gait data. Joint work was calculated as positive and negative components in six subphases during gait and normalised by speed when comparing the groups.

RESULTS

The CP group had a slower walking speed, smaller stride length and longer stance phase than the healthy group. Hip max positive work was 0.12 ± 0.02 Jkg/ms for the CP group in pre-mid-stance but 0.07 ± 0.01 Jkg/ms for the healthy group during the terminal phase. In terminal stance, ankle positive work was significantly lower in the CP group (0.12 ± 0.01) than in the healthy group (0.18 ± 0.01). The knee showed a similar distribution of positive work in the stance phase for the two groups. In the ankle and hip, the CP group had energy generation mainly in midstance while the healthy group was mainly in terminal stance. In the ankle, the CP group had larger energy absorption in mid-stance than the healthy children group, while the CP group showed lower energy generation in the terminal stance phase than seen in the healthy group.

CONCLUSION

The qualitative and quantitative analysis of joint work provides useful information for clinicians in the treatment and rehabilitation of CP patients.

摘要

目的

比较脑瘫(CP)患儿与健康儿童在步态周期不同子阶段下肢关节的协同工作情况。

方法

收集了18名脑瘫患儿和20名健康儿童的步态数据。脑瘫组包括使用矫形器、肌肉注射肉毒杆菌毒素和手术治疗的亚组。采用运动捕捉系统收集步态数据。在比较各组时,将步态中六个子阶段的关节功计算为正功和负功分量,并按速度进行归一化处理。

结果

与健康组相比,脑瘫组步行速度较慢,步幅较小,站立期较长。在站立前期至中期,脑瘫组髋关节最大正功为0.12±0.02Jkg/ms,而健康组在末期为0.07±0.01Jkg/ms。在站立末期,脑瘫组踝关节正功(0.12±0.01)显著低于健康组(0.18±0.01)。两组在站立期膝关节正功分布相似。在踝关节和髋关节方面,脑瘫组能量产生主要在站立中期,而健康组主要在站立末期。在踝关节,脑瘫组在站立中期的能量吸收比健康儿童组大,而在站立末期阶段,脑瘫组的能量产生低于健康组。

结论

关节功的定性和定量分析为临床医生治疗和康复脑瘫患者提供了有用信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8524/9385940/28fd273aef07/43465_2022_691_Fig1a_HTML.jpg

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