Department of Physical Therapy, I-Shou University, Kaohsiung, Taiwan, ROC.
Discipline of Physiotherapy, The University of Sydney, Lidcombe, Australia.
Sci Rep. 2023 Feb 24;13(1):3229. doi: 10.1038/s41598-023-30293-9.
The purpose of this study was to determine the relative contribution of sensory and motor impairments to mobility limitations in cerebral palsy. An observational study was carried out in 83 children with all types of cerebral palsy with a mean age of 10.8 years (SD 1.2). Five impairments (coordination, strength, spasticity, contracture, proprioception) and three aspects of mobility (standing up from a chair, short and long distance walking) were measured. Standard multiple regression was used to determine the relative contribution of impairments to mobility as well as the relative contribution of strength of individual muscle groups (dorsiflexors, plantarflexors, knee extensors, hip abductors and hip extensors) to mobility. Five impairments accounted for 48% of the variance in overall mobility (p < 0.001): coordination independently accounted for 9%, contracture for 4% and strength for 3% of the variance. Five muscle groups accounted for 53% of the variance in overall mobility (p < 0.001): hip extensors independently accounted for 9%, knee extensors for 4%, dorsiflexors for 4% and plantarflexors for 3% of the variance. Our findings demonstrate that the impairments making a significant independent contribution to mobility in pre-adolescent cerebral palsy were loss of coordination, loss of strength and contracture.
本研究旨在确定感觉和运动障碍对脑瘫患者活动受限的相对贡献。对 83 名患有各种类型脑瘫的儿童进行了一项观察性研究，这些儿童的平均年龄为 10.8 岁（标准差 1.2）。测量了 5 种障碍（协调、力量、痉挛、挛缩、本体感觉）和 3 个方面的移动能力（从椅子上站起来、短距离和长距离行走）。标准多元回归用于确定障碍对移动能力的相对贡献，以及个体肌肉群（背屈肌、跖屈肌、膝关节伸肌、髋关节外展肌和髋关节伸肌）的力量对移动能力的相对贡献。5 种障碍解释了整体移动能力的 48%（p<0.001）：协调独立解释了 9%的差异，挛缩占 4%，力量占 3%。5 个肌肉群解释了整体移动能力的 53%（p<0.001）：髋关节伸肌独立解释了 9%的差异，膝关节伸肌占 4%，背屈肌占 4%，跖屈肌占 3%。我们的研究结果表明，在青春期前脑瘫患者中，对移动能力有显著独立贡献的障碍是协调丧失、力量丧失和挛缩。
