痉挛型脑瘫儿童步态运动学特征

Kinematic Characteristics of Gait for Children with Spastic Cerebral Palsy

目的基于步态分析方法研究痉挛型脑瘫儿童行走的运动学特征。方法应用便携式步态分析仪对16例痉挛型脑瘫儿童和16例健康儿童平地常速来回行走的步态进行测试,比较痉挛型脑瘫儿童患侧与健侧、痉挛型脑瘫儿童与健康儿童的步态差异。结果与健侧相比,痉挛型脑瘫儿童患侧单步时间、摆动时间和跖骨离地期显著长于健侧（P 〈0. 05）,患侧步频、步速、支撑相末期显著低于健侧（P 〈0. 05）。痉挛型脑瘫儿童患侧步态周期时间、单步时间、站立时间、摆动时间、站立相所占百分比、支撑相中期、摆动前期和跖骨离地期相比于正常儿童均显著增加（P 〈0. 05）。痉挛型脑瘫儿童跨步长、步速、步频、支撑相末期相比于正常儿童均显著降低（P 〈0. 05）,拔腿强度也降低（P=0. 05）。结论痉挛型脑瘫儿童行走时稳定性降低,其患侧单步时间、摆动时间、跖骨离地期和拔腿强度或许可以作为敏感指标应用于临床评估,指导脑瘫儿童的康复治疗。

Objective To analyze kinematic characteristics of children with spastic cerebral palsy during walking based on the method of gait analysis. Methods The gait of 14 children with spastic cerebral palsy and 16 healthy children,who were required to walk back and forth on level ground at normal speed,was tested using portable gait analyzer. The gait differences between diseased side and healthy side of lower limbs for children with spastic cerebral palsy,as well as the gait differences between children with spastic cerebral palsy children and healthy children were compared. Results For children with spastic cerebral palsy,single step time,swing time and toeoff time of diseased side were significantly longer than those of healthy side（ P 〈0. 05）,while step frequency,velocity and terminal stance were significantly shorter than those of healthy side（ P〈 0. 05）. Compared with healthy children,gait cycle time,single step time,stance time,swing time,percentage of stance phase,mid stance phase,pre-swing stage and toe-off time for diseased side of children with spastic cerebral palsy were significantly longer（ P〈 0. 05）. Stride,velocity,step frequency and terminal stance of the children with spastic cerebral palsy were significantly lower than those of healthy children（ P 〈0. 05）. Pulling acceleration for children with spastic cerebral palsy also decreased compared with healthy children（ P = 0. 05）. Conclusions The stability of children with spastic cerebral palsy decreased during walking,and their single step time,swing time,toe-off time and pulling acceleration might be considered as the sensitive indicators.