足底四等份足印分析法在脑性瘫痪评价中的意义

Value of the footprint analysis with four equal proportions of foot sole in the evaluation of cerebral palsy

目的:比较脑性瘫痪患儿与健康儿童足底四等份足印分析法量化评价结果。方法:选择1998-01/2000-12济南市儿童医院脑瘫康复中心收治的3～5岁痉挛型脑瘫患儿139例为患儿组,男76例,女63例。选择同期于本院进行健康体检的同年龄段健康儿童800人为正常组,男400人,女400人。监护人均同意参加。测量纳入对象身高、体质量。采用自行研制的宽1m、长5m的印油毯作为留足印的步道。在印油毯上印一个完整的站立足印,再嘱受试者双眼平视前方,以自然行走的方式走过步道,测量步速(步速=步幅÷步行周期)。根据足印测量法及自行设计的足底四等份法分别测量中间6个足印的足纵轴线内外宽度(足宽)并取平均值。计量资料差异性测定采用U检验。结果:脑性瘫痪患儿139例,正常儿童800人均进入结果分析。①左足纵轴线上内外侧宽度、左足纵轴线中内侧宽度、右足纵轴线上内外侧宽度、右足纵轴线中内侧宽度:患儿组明显高于正常组(P<0.05～0.01)。②左足纵轴线中外侧宽度、左足纵轴线下内外侧宽度、右足纵轴线中外侧宽度、右足纵轴线下内外侧宽度:患儿组明显低于正常组(P<0.05～0.01)。③步速:患儿组明显大于正常组(P<0.05)。结论:脑性瘫痪患儿与健康儿童足底四等份足印分析法量化评价结果差异明显,足底四等份足印分析法可量化评价脑性瘫痪患儿足内、外翻或扁平足的程度。

AIM： To compare the quantitative evaluation results of the footprint analysis with four equal proportions of foot sole between children with cerebral palsy and healthy children. METHODS： From January 1998 to December 2000, 139 children（male 76 and female 63） with spastic cerebral palsy at the age of 3 to 5 years were selected from the Center for Rehabilitation of Cerebral Palsy, Jinan Children＇s Hospital for the cerebral palsy group, and 800 healthy children （male 400 and female 400） at the age of 3 to 5 years after health examination were selected from the same hospital for the control group. All the guardians were consent about our investigation. The body height and body mass were measured in all the subjects. A piece of self-prepared printed linoleum 1 m in width and 5 m in length was used as the footpath for footprints. Each child should tread out an intact footprint on the printed linoleum, then was told to look forwards and walked naturally passing the footpath to measure the gait speed（gait speed=ratio of gait extent to cycle of gait）.The self-designed four equal proportions of foot sole and measurement method for footprint was used to measure the longitudinal medial and lateral width （foot width） of 6 middle footprints, and the values were averaged. The difference of measurement data was detected by U test. RESULTS：. All the 139 children with cerebral palsy and 800 healthy children were involved in the result analysis. ①The longitudinal upper medial and lateral width and middle medial width of left and right feet were significantly longer in the cerebral palsy group than in the control group （P 〈 0.05 to 0.01）. ②The longitudinal middle lateral width, lower medial and lateral width of left and right feet were significantly shorter in the cerebral palsy group than in the control group（P 〈 0,05 to 0.01）. ③The gait speed in the cerebral palsy group was significantly faster than that in the control group（P 〈 0.05）. CONCLUSION： There was significant difference between the children with cerebral palsy and the health children evaluated by footprint analysis with four equal proportions of foot sole. The footprint analysis with four equal proportions of foot sole can be used to evaluate the degree of foot inversion and eversion, and flatfoot in the children with cerebral palsy quantitatively.