Department of Physical Therapy, Takasaki University of Health and Welfare, 501 Nakaorui-Machi, Takasaki, Gunma, 370-0033, Japan.
Department of Rehabilitation, Tsukuba Memorial Hospital, 1187-299 Kaname, Tsukuba, Ibaraki, 300-2622, Japan.
J Med Ultrason (2001). 2023 Apr;50(2):245-252. doi: 10.1007/s10396-023-01292-0. Epub 2023 Mar 30.
We examined the association of activities of daily living (ADL) and cognitive function with the upper extremity muscle thickness and upper extremity range of motion (ROM) and spasticity in children and adults with cerebral palsy (CP).
The subjects were 20 children and adults with CP. The ADL performed using the upper extremities and cognitive function were assessed using the self-care domain of the Pediatric Evaluation of Disability Inventory (PEDI) and the full-scale intelligence quotient (FSIQ) of the Wechsler Intelligence Scale for Children, fourth edition (WISC-IV), respectively. The WISC-IV was assessed in only seven of 20 subjects able to undergo evaluation. The thickness of the upper extremity muscles was measured using an ultrasound imaging device. Moreover, ROM and spasticity of the upper extremities were assessed using the Modified Ashworth Scale (MAS). Manual manipulation ability was also assessed using the Manual Ability Classification System (MACS).
Stepwise regression analysis revealed that the extensor digitorum muscle thickness and MACS level were significant and independent factors of self-care in the PEDI. Partial correlation analysis with MACS level and age as control variables showed that the FSIQ of the WISC-IV was significantly associated with the thickness of the anterior fibers of the deltoid and flexor digitorum superficialis muscles.
Reduced ADL performed using the upper extremities is associated with decreased extensor digitorum muscle thickness rather than ROM and spasticity of the upper extremities in children and adults with CP.
我们研究了日常生活活动（ADL）和认知功能与脑瘫患儿和成人上肢肌肉厚度、上肢活动范围（ROM）和痉挛之间的关系。
研究对象为 20 名脑瘫患儿和成人。使用 Pediatric Evaluation of Disability Inventory（PEDI）的自理领域和 Wechsler Intelligence Scale for Children，第四版（WISC-IV）的全智商（FSIQ）评估上肢的 ADL 和认知功能。只有 20 名受试者中的 7 名能够接受 WISC-IV 的评估。使用超声成像设备测量上肢肌肉的厚度。此外，使用改良 Ashworth 量表（MAS）评估上肢的 ROM 和痉挛。使用手动能力分类系统（MACS）评估手动操作能力。
逐步回归分析显示，伸指肌厚度和 MACS 水平是 PEDI 自理的显著独立因素。以 MACS 水平和年龄为控制变量的偏相关分析显示，WISC-IV 的 FSIQ 与三角肌前纤维和指浅屈肌的厚度显著相关。
脑瘫患儿和成人上肢 ADL 减少与伸指肌厚度降低有关，而与上肢 ROM 和痉挛无关。
