From the Department of Orthopedics, Heidelberg University Hospital, Heidelberg, Germany. (Dr. Horsch, Dr. Kleiber, Dr. Ghandour, Dr. Deisenhofer, and Dr. Putz); Department Orthopedics and Trauma Surgery, Marienkrankenhaus Soest, Soest, Germany (Dr. Klotz); Department of Orthopaedics and Traumatology, St. Josef-Hospital, Ruhr University Bochum, Bochum, Germany (Dr. Klotz).
J Am Acad Orthop Surg Glob Res Rev. 2024 Mar 25;8(4). doi: 10.5435/JAAOSGlobal-D-24-00039. eCollection 2024 Apr 1.
To determine whether differences exist in the measured range of motion (ROM) by the goniometer, equinometer, and 3-dimensional (3D) gait analysis in different settings (under general anesthesia (GA) or in the clinic) among patients with cerebral palsy.
A prospective comparative cohort study was conducted at our orthopaedics center, where 15 patients with diplegic cerebral palsy (30 limbs) were evaluated, all of whom had Gross Motor Function Classification System (GMFCS) level I and II. ROM was measured by (1) goniometer under GA (benchmark), (2) goniometer analysis during clinical examination, (3) equinometer under GA, (4) equinometer in the clinic, and (5) 3D gait analysis. ROM was measured during both knee flexion and extension. Subgroup analysis based on the GMFCS level was performed.
Nine patients were male with GMFCS level I and a mean age of 14.3 (SD=7.2) years. Statistically significant differences were noted between all studied measurement techniques in terms of ROM, dorsiflexion, and plantarflexion during both knee flexion and extension. The GMFCS level was an effect modifier of ROM measurements.
The ROM parameters during both knee flexion and extension differed from one measurement device/technique to another. The GMFCS level played a notable effect-modifying role on the ROM parameters.
本研究旨在确定在不同环境（全麻（GA）或临床检查）下，痉挛型脑瘫患者使用量角器、量足计和三维（3D）步态分析测量的运动范围（ROM）是否存在差异。
本前瞻性对比队列研究在我院骨科中心进行，共纳入 15 例双瘫脑瘫患者（30 条肢体），所有患者均为粗大运动功能分级系统（GMFCS）I 级和 II 级。ROM 通过（1）GA 下量角器（基准）、（2）临床检查时量角器分析、（3）GA 下量足计、（4）临床检查时量足计和（5）3D 步态分析进行测量。分别在膝关节屈伸时测量 ROM。并进行了基于 GMFCS 分级的亚组分析。
9 例男性患者，GMFCS 分级 I，平均年龄 14.3（SD=7.2）岁。在膝关节屈伸时，所有研究测量技术的 ROM、背屈和跖屈均存在显著差异。GMFCS 分级是 ROM 测量的效应修饰因子。
膝关节屈伸时的 ROM 参数在不同的测量设备/技术之间存在差异。GMFCS 分级对 ROM 参数具有显著的效应修饰作用。
