Szopa Andrzej, Domagalska-Szopa Małgorzata
Department of Physiotherapy, Medical University of Silesia in Katowice, 40-752 Katowice, Poland.
Neuromed, Rehabilitation and Medical Center, 40-698 Katowice, Poland.
J Clin Med. 2024 Sep 5;13(17):5263. doi: 10.3390/jcm13175263.
A lack of postural control is one of the key problems in children with cerebral palsy (CP). The goals of the present study were to assess static postural stability in children with mild CP using a force platform compared to that of typically developing peers and to identify differences in static stability between children with hemiplegic and diplegic CP. This study included 45 children with hemiplegic CP and 45 children with well-functioning diplegic CP (Gross Motor Function Classification System; GMFCS scores between I and II) who were patients of local paediatric rehabilitation centres. The testing procedure included two interrelated parts: (1) the analysis of the body weight distribution and (2) the posturometric test (the centre of pressure; CoP measurements) using the force platform. The results of the present study show that children with CP, compared to their TD peers, demonstrated significantly higher values for all of the analysed indexes of postural stability. The obtained results indicate differences in disorders of static postural stability between children with hemiplegic and diplegic CP. Compared to their TD peers, children with hemiplegic CP showed greater body weight asymmetry between the affected and unaffected sides of the body and greater CoP sway in the medial-lateral direction. In contrast, children with diplegic CP exhibited greater CoP displacements in the anterior-posterior direction. The findings of the present study show that (1) children with CP have increased static postural instability compared to their TD peers and (2) children with diplegic CP exhibit weaker mediolateral stability in standing, whereas children with hemiplegic CP show reduced anterior-posterior stability.
姿势控制能力不足是脑瘫(CP)儿童的关键问题之一。本研究的目的是使用测力平台评估轻度脑瘫儿童与正常发育同龄人相比的静态姿势稳定性,并确定偏瘫型和双瘫型脑瘫儿童在静态稳定性方面的差异。本研究纳入了45名偏瘫型脑瘫儿童和45名功能良好的双瘫型脑瘫儿童(粗大运动功能分类系统;GMFCS评分在I级和II级之间),他们均为当地儿科康复中心的患者。测试程序包括两个相互关联的部分:(1)体重分布分析和(2)使用测力平台进行姿势测量测试(压力中心;CoP测量)。本研究结果表明,与正常发育的同龄人相比,脑瘫儿童在所有分析的姿势稳定性指标上均表现出显著更高的值。所得结果表明偏瘫型和双瘫型脑瘫儿童在静态姿势稳定性障碍方面存在差异。与正常发育的同龄人相比,偏瘫型脑瘫儿童身体患侧和未患侧之间的体重不对称更大,并且在内外侧方向上的CoP摆动更大。相比之下,双瘫型脑瘫儿童在前后方向上表现出更大的CoP位移。本研究结果表明:(1)与正常发育的同龄人相比,脑瘫儿童的静态姿势不稳定性增加;(2)双瘫型脑瘫儿童在站立时表现出较弱的内外侧稳定性,而偏瘫型脑瘫儿童则表现出前后稳定性降低。