de Paula Paro Marisa, de Sousa Raísa Marques, Martinez Juliana Perez, Simcsik Amanda Orasmo, Airoldi Marina Junqueira, Dias Rodrigo Martins, de Moraes Íbis Ariana Peña, Magalhães Fernando Henrique, de Mello Monteiro Carlos Bandeira, da Silva-Magalhães Talita Dias
Graduate Program in Medicine (Cardiology), Escola Paulista de Medicina, Federal University of São Paulo (EPM/UNIFESP), São Paulo 03828-000, Brazil.
Graduate Program in Physical Activity Sciences, School of Arts, Science and Humanities of University of São Paulo (EACH-USP), São Paulo 03828-000, Brazil.
Brain Sci. 2024 Sep 30;14(10):1000. doi: 10.3390/brainsci14101000.
Cerebral palsy (CP) is a group of movement disorders that impair posture and mobility, often leading to spasticity and joint contractures. Interventions like serial casting are commonly used to improve joint mobility and manage spasticity in children with CP. However, its effects on the autonomic nervous system (ANS) remain unclear. This study aimed to evaluate the effects of serial casting and ankle-foot orthoses (AFOs) on ANS responses during a virtual reality (VR) standing task, comparing these interventions with a barefoot condition. Thirty children with CP were randomized into three groups ( = 10 per group): serial casting, AFOs, and barefoot. Heart rate variability (HRV) was used to assess ANS responses across three phases: seated rest, VR task, and recovery. The results showed that the serial casting group exhibited higher sympathetic activity during rest compared to the other groups, but had a reduced sympathetic response during the VR task. Additionally, the serial casting group displayed a more pronounced parasympathetic rebound during recovery, similar to the orthoses and barefoot groups. While serial casting provides essential joint stability, it alters ANS response patterns, leading to heightened sympathetic activation at rest, without providing significant improvements in ANS behavior during physical activity.
脑性瘫痪（CP）是一组运动障碍，会损害姿势和活动能力，常导致痉挛和关节挛缩。像连续石膏固定这样的干预措施通常用于改善CP患儿的关节活动度并控制痉挛。然而，其对自主神经系统（ANS）的影响仍不清楚。本研究旨在评估连续石膏固定和踝足矫形器（AFO）在虚拟现实（VR）站立任务期间对ANS反应的影响，并将这些干预措施与赤脚状态进行比较。30名CP患儿被随机分为三组（每组 = 10名）：连续石膏固定组、AFO组和赤脚组。心率变异性（HRV）用于评估三个阶段的ANS反应：静息坐位、VR任务和恢复阶段。结果显示，与其他组相比，连续石膏固定组在静息时表现出更高的交感神经活动，但在VR任务期间交感神经反应降低。此外，连续石膏固定组在恢复阶段表现出更明显的副交感神经反弹，与矫形器组和赤脚组相似。虽然连续石膏固定提供了必要的关节稳定性，但它会改变ANS反应模式，导致静息时交感神经激活增强，而在身体活动期间ANS行为并未得到显著改善。
