Gómez-Pérez Cristina, Vidal Samsó Joan, Puig Diví Albert, Medina Casanovas Josep, Font-Llagunes Josep M, Martori Joan Carles
Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M(3)O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), Vic, Spain.
Institut Guttmann, Hospital de Neurorehabilitació, Badalona, Spain; Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain; Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Spain.
J Orthop Sci. 2023 Sep;28(5):1136-1142. doi: 10.1016/j.jos.2022.08.011. Epub 2022 Oct 7.
Understanding the links between gait disorders, impairments, and activity limitations is essential for correctly interpreting the instrumented gait analysis. We aimed to evaluate the relationships between spatiotemporal parameters and clinical outcomes in children with bilateral spastic cerebral palsy, and find out whether spatiotemporal parameters provide clinical information regarding gait pattern and walking.
Data from 19 children with bilateral spastic cerebral palsy (nine males, ten females, 9.6 ± 2.8 years old) were collected retrospectively. All children underwent an instrumented gait analysis and a standardized clinical assessment. Seven spatiotemporal parameters were calculated: non-dimensional cadence, stride length, step width, gait speed, first double support, single support, and time of toe off. Clinical outcomes included measures of two different components of the International Classification of Functioning, Disability and Health - Children and Youth version: body functions and structures (spasticity, contractures and range of motion, and deformities), and activities and participation (gross motor function, and walking capacity). Pearson correlation, ANOVA, Student's t, Mann-Whitney U, and Kruskal-Wallis tests were used to analyze relationships. Spatiotemporal parameters related to clinical outcomes of body functions and structures were interpreted as outcome measures of gait pattern, while those related to clinical outcomes of activities and participation were interpreted as outcome measures of walking.
Non-dimensional cadence, stride length, and gait speed showed relationships (p < 0.05) with hip flexors spasticity and hindfoot deformity, ankle plantar flexors spasticity, and hindfoot deformity, respectively. All spatiotemporal parameters except non-dimensional cadence showed correlation (p < 0.05) with gross motor function and walking capacity.
Spatiotemporal parameters provide clinical information regarding both gait pattern and walking.
了解步态障碍、功能损伤和活动受限之间的联系对于正确解读仪器化步态分析至关重要。我们旨在评估双侧痉挛性脑瘫患儿的时空参数与临床结局之间的关系，并确定时空参数是否能提供有关步态模式和行走的临床信息。
回顾性收集了19例双侧痉挛性脑瘫患儿（9例男性，10例女性，9.6±2.8岁）的数据。所有患儿均接受了仪器化步态分析和标准化临床评估。计算了七个时空参数：无量纲步频、步长、步宽、步态速度、首次双支撑时间、单支撑时间和足趾离地时间。临床结局包括《国际功能、残疾和健康分类-儿童和青少年版》两个不同组成部分的测量指标：身体功能和结构（痉挛、挛缩和活动范围以及畸形），以及活动和参与（粗大运动功能和行走能力）。使用Pearson相关性分析、方差分析、Student's t检验、Mann-Whitney U检验和Kruskal-Wallis检验来分析关系。与身体功能和结构临床结局相关的时空参数被解释为步态模式的结局指标，而与活动和参与临床结局相关的时空参数被解释为行走的结局指标。
无量纲步频、步长和步态速度分别与髋屈肌痉挛和后足畸形、踝跖屈肌痉挛和后足畸形呈相关性（p<0.05）。除无量纲步频外，所有时空参数均与粗大运动功能和行走能力呈相关性（p<0.05）。
时空参数提供了有关步态模式和行走的临床信息。
