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[婴儿期下肢痉挛性运动障碍的简易检查]

[Simple examination of spastic movement disorders of the lower limbs in the infant age].

作者信息

Haberfellner H, Haffner B

出版信息

Padiatr Padol. 1977;12(4):377-84.

PMID:904945
Abstract

In 334 children active dorsiflexion of the feet was tested in order to screen for spasticity of the lower limbs. The conditions were: 1. The child lying supine. 2. The head turned actively and if this is not possible passively to the side of the examined foot. 3. Passive extension of the child's hip and knee of the examined side by the examinator. 4. Stimulation of the skin at the lateral and lower part of the shin, or the dorsum pedis or the anterior part of the toes and the planta pedis to provoke active dorsiflexion of the foot. Stimulation is done by the fingers of the examinator or by a slight touch with an ordinary handbrush. Dorsiflexion of the foot is graded "normal" if it surpasses 90--100 degrees, "suspicious" if it only reaches 90 degrees and "pathologic" if 90 degrees cannot be reached or if this can be done only on the medial side or if there is constant clawing of the toes even with sufficient dorsiflexion. We have examined 334 children; 260 of these were younger than one year. The results of this kind of stimulated dorsiflexion of the foot were compared with the results of the usual extensive neurological examination with regard to spasticity of the lower limbs (see literature) and with both of VOJTA's most sensible postural reactions. The following conclusions are drawn: 1. Spasticity of the lower limbs can be excluded with a high degree of probability when dorsiflexion of the feet is graded "normal". 2. If the dorsiflexion is graded "suspicious" or "pathologic" a more thorough neurological examination is warranted and if necessary short-term controls. 3. The results of this examination are in good agreement with the one of VOJTA's most sensitive postural reactions to indicate spasticity of the lower limbs.

摘要

对334名儿童进行了足部主动背屈测试,以筛查下肢痉挛情况。测试条件如下:1. 儿童仰卧。2. 头部主动转向检查侧足部所在方向,若无法主动转动,则被动转向。3. 检查者被动伸展被检查侧儿童的髋部和膝部。4. 刺激小腿外侧及下部、足背、脚趾前部或足底,以引发足部主动背屈。刺激可通过检查者手指或用普通手刷轻轻触碰来完成。若足部背屈超过90 - 100度,则评定为“正常”;若仅达到90度,则评定为“可疑”;若无法达到90度,或只能在内侧达到,或即使背屈充分但仍有持续的脚趾爪形畸形,则评定为“病理”。我们检查了334名儿童;其中260名年龄小于1岁。将这种刺激后足部背屈的结果与针对下肢痉挛的常规全面神经检查结果(见文献)以及VOJTA最敏感的两种姿势反应结果进行了比较。得出以下结论:1. 当足部背屈评定为“正常”时,可高度排除下肢痉挛。2. 若背屈评定为“可疑”或“病理”,则有必要进行更全面的神经检查,必要时进行短期复查。3. 该检查结果与VOJTA最敏感的一种用于指示下肢痉挛的姿势反应结果高度一致。

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