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脑瘫儿童后退行走与本体感觉、躯干控制和肌肉力量的关系。

The relationship between the backward walking and proprioception, trunk control, and muscle strength in children with cerebral palsy.

机构信息

Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, SANKO University, 27090, Gaziantep, Turkey.

Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Kahramanmaras Sutcu Imam University, 46100, Kahramanmaras, Turkey.

出版信息

Ir J Med Sci. 2023 Oct;192(5):2391-2399. doi: 10.1007/s11845-022-03270-w. Epub 2023 Jan 6.

Abstract

OBJECTIVE

This study was planned to determine the factors affecting backward walking in children with cerebral palsy (CP).

METHODS

The study included 30 children with CP, with a mean age of 10.43 ± 2.76 years. Backward walking abilities were evaluated with the 3-Meter Back Walk Test (3MBWT). A digital goniometer was used to evaluate proprioception, the Trunk Control Measurement Scale (TCMS) was used for trunk control, a digital muscle dynamometer was used for muscle strength, and the Gillette Functional Assessment Questionnaire (FAQ) was used for gait evaluation.

RESULTS

When the spasticity of children at levels I and II according to the Gross Motor Function Classification System (GMFCS) was compared, a significant difference was found in favor of level I in hamstring, gastro-soleus, and gastrocnemius spasticity (p < 0.05). When the results of the 3MBWT, TCMS, and FAQ were compared, a significant difference was found in favor of level I (p < 0.05). No significant relationship was revealed between the 3MBWT and lower extremity proprioception and TCMS (p > 0.05). A significant negative correlation was observed between the 3MBWT and FAQ (p < 0.05). No significant correlation was found between the 3MBWT and lower extremity muscle strengths (p > 0.05). A significant positive correlation was found only between hip extension proprioception and iliopsoas muscle strength (p = 0.023). There was no significant correlation between the FAQ and lower extremity muscle strength (p > 0.05).

CONCLUSION

It was revealed that the backward walking ability increased as the forward walking function improved in children with CP, but it was not affected by proprioception, trunk control, and muscle strength.

CLINICAL TRIALS

NCT05088629 (10/11/2021).

摘要

目的

本研究旨在确定影响脑瘫(CP)儿童倒走的因素。

方法

本研究纳入 30 名 CP 儿童,平均年龄为 10.43±2.76 岁。采用 3 米后退步行测试(3MBWT)评估后退步行能力。使用数字量角器评估本体感觉,使用躯干控制测量量表(TCMS)评估躯干控制,使用数字肌肉测力计评估肌肉力量,使用吉尔伯特功能评估问卷(FAQ)评估步态。

结果

当根据粗大运动功能分类系统(GMFCS)将儿童的痉挛程度分为 I 级和 II 级进行比较时,发现 I 级的腘绳肌、比目鱼肌和腓肠肌痉挛程度更有利(p<0.05)。当比较 3MBWT、TCMS 和 FAQ 的结果时,发现 I 级的结果更有利(p<0.05)。3MBWT 与下肢本体感觉和 TCMS 之间未显示出显著关系(p>0.05)。3MBWT 与 FAQ 之间存在显著负相关(p<0.05)。3MBWT 与下肢肌肉力量之间未发现显著相关性(p>0.05)。仅观察到髋关节伸展本体感觉与髂腰肌力量之间存在显著正相关(p=0.023)。FAQ 与下肢肌肉力量之间未显示出显著相关性(p>0.05)。

结论

研究表明,脑瘫儿童的后退行走能力随着向前行走功能的提高而提高,但不受本体感觉、躯干控制和肌肉力量的影响。

临床试验

NCT05088629(2021 年 11 月 10 日)。

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