Center for Gait and Motion Analysis, Gillette Children's, Saint Paul, MN, USA.
Department of Orthopedic Surgery, University of Minnesota - Twin Cities, Minneapolis, MN, USA.
J Pediatr Rehabil Med. 2024;17(1):75-83. doi: 10.3233/PRM-220140.
There is no established clinical standard to evaluate ankle proprioception in children with cerebral palsy (CP). This study compared ankle position sense of children with CP to age-matched children who are typically developing (TD).
Children aged 6-17 years participated (15 CP, 58 TD). Using a custom-built device, the ankle was passively rotated to two positions for 25 trials. Using a psychophysical forced-choice paradigm, participants indicated which position was more plantarflexed. A psychometric function was fitted to the response data to determine the just noticeable difference (JND) threshold and the associated uncertainty (random error) for ankle position sense.
Median JND thresholds for the CP group were elevated (CP: 4.3°, TD: 3.0°). Three children with CP exceeded the 95th percentile of TD. No differences in random error were found.
This method assessed ankle proprioception relative to norm data and identified position sense impairments in children with CP. Using this method can provide data on proprioceptive status in CP, augmenting the assessment of motor impairment.
目前尚无评估脑瘫（CP）儿童踝关节本体感觉的临床标准。本研究比较了 CP 患儿和年龄匹配的正常发育（TD）儿童的踝关节位置感。
6-17 岁的儿童参与了研究（15 名 CP，58 名 TD）。使用定制的设备，踝关节被动旋转至两个位置进行 25 次试验。参与者使用心理物理强迫选择范式来表示哪个位置跖屈程度更大。使用心理物理函数拟合响应数据以确定踝关节位置感觉的可察觉差异（JND）阈值和相关不确定性（随机误差）。
CP 组的中位数 JND 阈值升高（CP：4.3°，TD：3.0°）。3 名 CP 患儿的 JND 阈值超过了 TD 的第 95 百分位数。随机误差无差异。
该方法相对于正常数据评估了踝关节本体感觉，并确定了 CP 儿童的位置感觉障碍。使用这种方法可以提供 CP 中本体感觉状态的数据，从而补充运动障碍的评估。
