儿童和青少年腓骨肌萎缩症的振动感知与足弓形态的关系。
Vibration perception among children and adolescents with Charcot-Marie-tooth disease and implications for foot posture.
机构信息
Health Science Department, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.
Physical Therapy, Speech, and Occupational Therapy Department, School of Medicine, University of São Paulo, São Paulo, Brazil.
出版信息
Clin Biomech (Bristol). 2023 Dec;110:106114. doi: 10.1016/j.clinbiomech.2023.106114. Epub 2023 Sep 28.
BACKGROUND
Alterations in vibration perception among children and adolescents with Charcot-Marie-Tooth disease might explain observed changes in foot posture. Therefore, this cross-sectional study compared the vibration perception of the lower limbs in youths with and without Charcot-Marie-Tooth disease and verified the cut-off value of the distal vibration perception for the Charcot-Marie-Tooth group. In addition, associations between dynamic plantar pressure, vibration perception and isometric muscle strength were investigated.
METHODS
Participants aged 9-18 (Charcot-Marie-Tooth group n = 32; Typical group n = 32) had vibration perception measured by a 128-Hz graduated tuning fork. The static and dynamic foot posture were evaluated by the Foot Posture Index and pressure distribution measuring system, respectively. For the Charcot-Marie-Tooth group, a hand-held dynamometer evaluated the isometric muscle strength of the lower limbs.
FINDINGS
Children with Charcot-Marie-Tooth disease presented impaired vibration perception at the distal phalanx of the hallux and head of the first metatarsal compared to their typically developing peers, while adolescents with Charcot-Marie-Tooth disease showed impairment in all the tested regions compared to their typically developing peers. The cut-off value for vibration perception for participants with Charcot-Marie-Tooth disease was 5.7, considering the original grade of the tuning-fork 128 Hz. Among the associations established for the Charcot-Marie-Tooth group, a greater vibration perception at the distal phalanx of the hallux was associated with a longer rearfoot contact time (β = 31.02, p = 0.04).
INTERPRETATION
These new findings may guide the clinical evaluation and rehabilitation treatment for children and adolescents with Charcot-Marie-Tooth disease.
背景
小儿腓骨肌萎缩症患者下肢振动觉的改变可能解释了观察到的足部姿势的变化。因此，本横断面研究比较了小儿腓骨肌萎缩症患者和非小儿腓骨肌萎缩症患者下肢的振动觉，并验证了小儿腓骨肌萎缩症组的远端振动觉截断值。此外，还研究了动态足底压力、振动觉和等长肌肉力量之间的相关性。
方法
9-18 岁的参与者（腓骨肌萎缩症组 n=32；典型组 n=32）使用 128Hz 的音叉测量振动觉。静态和动态足部姿势分别通过足部姿势指数和压力分布测量系统进行评估。对于腓骨肌萎缩症组，使用手持测力计评估下肢等长肌肉力量。
发现
与发育正常的同龄人相比，患有腓骨肌萎缩症的儿童在大脚趾的远节趾骨和第一跖骨头的振动觉受损，而青少年腓骨肌萎缩症患者在所有测试区域的振动觉均受损，与发育正常的同龄人相比。考虑到音叉 128Hz 的原始等级，腓骨肌萎缩症患者的振动觉截断值为 5.7。在腓骨肌萎缩症组建立的相关性中，大脚趾远节趾骨的振动觉越强，跟骨接触时间越长（β=31.02，p=0.04）。
结论
这些新发现可能为小儿腓骨肌萎缩症患者的临床评估和康复治疗提供指导。
Zotero 插件