Kelly I P, Jenkinson A, Stephens M, O'Brien T
Central Remedial Clinic, Dublin, Ireland.
J Pediatr Orthop. 1997 Jul-Aug;17(4):478-80.
Children who toe-walk can pose a diagnostic problem. The differential diagnosis includes mild spastic diplegia and idiopathic toe-walking. Clinical differentiation between these two patient groups can be particularly difficult, and there are no objective diagnostic tests to assist the clinician. We assessed 50 children who toe-walk to define the kinematic patterns of lower-limb joint motion in the sagittal plane. There were 23 children with mild spastic diplegia. 22 idiopathic toe-walkers, and five normal children who were asked to toe-walk. We found characteristic patterns of knee and ankle motion that differentiated spastic diplegia from idiopathic toe-walking. Normal children asked to toe-walk had the same pattern as the idiopathic group. Gait analysis is a diagnostic tool that enables the clinician objectively to differentiate mild spastic diplegia from idiopathic toe-walking.
用脚尖走路的儿童可能会带来诊断难题。鉴别诊断包括轻度痉挛性双侧瘫和特发性脚尖走路。这两组患者之间的临床鉴别可能特别困难，而且没有客观的诊断测试来帮助临床医生。我们评估了50名用脚尖走路的儿童，以确定矢状面下肢关节运动的运动学模式。其中有23名患有轻度痉挛性双侧瘫的儿童。22名特发性脚尖走路者，以及5名被要求用脚尖走路的正常儿童。我们发现了膝关节和踝关节运动的特征模式，可将痉挛性双侧瘫与特发性脚尖走路区分开来。被要求用脚尖走路的正常儿童与特发性组有相同的模式。步态分析是一种诊断工具，可使临床医生客观地将轻度痉挛性双侧瘫与特发性脚尖走路区分开来。
