改善躯干姿势控制有助于脑瘫儿童行走：一项初步研究。
Improving Trunk Postural Control Facilitates Walking in Children With Cerebral Palsy: A Pilot Study.
机构信息
From the Legs and Walking Lab, Shirley Ryan AbilityLab, Chicago, Illinois (SY, SHP, RK, WD, A-MR, WZR, MW); Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, Illinois (SY, SHP, A-MR, WZR, MW); and Department of Biomedical Engineering, University of Illinois at Chicago, Chicago, Illinois (MW).
出版信息
Am J Phys Med Rehabil. 2023 Sep 1;102(9):795-802. doi: 10.1097/PHM.0000000000002206. Epub 2023 Feb 8.
OBJECTIVE
The aim of this study is to determine the effects of bilateral trunk support during walking on trunk and leg kinematics and neuromuscular responses in children with cerebral palsy.
DESIGN
Fourteen children with spastic cerebral palsy (Gross Motor Function Classification System level I to III) participated in this study. Children walked on a treadmill under four different conditions, that is, without support (Baseline), with bilateral support applied to the upper trunk (upper trunk support), the lower trunk (lower trunk support), and combined upper and lower trunk (combined trunk support). The trunk and leg kinematics and muscle activity were recorded.
RESULTS
Providing bilateral support to the trunk had a significant impact on the displacement of the pelvis and trunk ( P < 0.003) during walking. Children's weaker leg showed greater step length ( P = 0.032) and step height ( P = 0.012) in combined trunk support compared with baseline and greater step length in upper trunk support ( P = 0.02) and combined trunk support ( P = 0.022) compared with lower trunk support. Changes in soleus electromyographic activity during stance phase of gait mirrored the changes in step length across all conditions.
CONCLUSIONS
Providing bilateral upper or combined upper and lower trunk support during walking may induce improvements in gait performance, which may be due to improved pelvis kinematics. Improving trunk postural control may facilitate walking in children with cerebral palsy.
目的
本研究旨在探讨在行走过程中双侧躯干支撑对脑瘫儿童躯干和下肢运动学及神经肌肉反应的影响。
设计
本研究纳入 14 名痉挛型脑瘫患儿（粗大运动功能分级系统 I 级至 III 级）。儿童在跑步机上以 4 种不同条件行走，即无支撑（基线）、上躯干（上躯干支撑）、下躯干（下躯干支撑）和上下躯干联合支撑（联合躯干支撑）。记录了躯干和下肢的运动学和肌肉活动。
结果
在行走过程中，为躯干提供双侧支撑对骨盆和躯干的位移有显著影响（P<0.003）。在联合躯干支撑下，患儿较弱侧下肢的步长（P=0.032）和步高（P=0.012）均大于基线，而上躯干支撑和联合躯干支撑下的步长也大于下躯干支撑（P=0.02 和 P=0.022）。在所有条件下，跟腱肌在步态站立相的肌电活动变化与步长变化一致。
结论
在行走过程中提供双侧上躯干或联合上、下躯干支撑可能会改善步态表现，这可能是由于骨盆运动学的改善。改善躯干姿势控制可能有助于脑瘫儿童的行走。
Zotero 插件