痉挛型脑瘫患儿步态的膝-踝关节运动协调性的分析

Analysis of gait intra-limb knee/ankle coordination in children with spastic cerebral palsy

目的对痉挛型脑瘫患儿与正常儿童步态的膝、踝关节角度变化和膝-踝关节运动协调性进行分析,为痉挛性脑瘫患儿步行能力的评价提供参考。方法利用三维运动捕捉系统采集观察组28例痉挛型脑瘫患儿和对照组24例正常儿童的关节角度数据;利用独立样本均数t检验和一般线性模型分析(GLM)对实验数据进行处理。结果①观察组膝、踝关节活动范围均小于对照组。经t检验,两组膝、踝关节活动范围均有显著性差异(P<0.01)。②经多变量方差分析,两组的步态协调性指数之间有显著性差异(P<0.01);经t检验,两组对应肢体在步态周期各关键点(除右足着地外)的膝-踝关节协调性指数均有显著性差异(P<0.05)。结论痉挛性脑瘫患儿膝、踝关节活动范围小于正常儿童;步态周期关键点膝-踝关节协调性指数可作为痉挛性脑瘫患儿步行能力的评价指标。

Objective To provide reference for walking ability evaluation of children with spastic cerebral palsy（SCP） by analyzing gait knee and ankle angle variation and intra-limb knee/ankle coordination in children with SCP and typically developing children.Methods With the application of 3D motion capture system,gait knee and ankle angle of 28 children with SCP and 24 typically developing children were sampled.Gait data was analyzed by independent sample t test and general lineal models（GLM）.Results ① The range of knee and ankle motion in observation group was smaller than that in control group.There was a significant difference in the ranges of knee and ankle motion between the two groups by independent sample t test（P〈0.01）.② Multivariate analysis of variance revealed that intra-limb knee /ankle index coordination significantly differed between the two groups（P〈0.01）.There was a significant difference in intra-limb knee /ankle coordination index of each gait event,except that the right foot touched the ground first between the two groups by independent sample t test（P〈0.05）.Conclusion The range of knee and ankle motion of children with SCP is smaller than that of typically developing children.The analysis of intra-limb knee/ankle coordination index of gait event is helpful to the evaluation of walking ability of children with SCP.