Determinants of gait dystonia severity in cerebral palsy.
Determinants of gait dystonia severity in cerebral palsy.
复制标题
脑瘫步态肌张力障碍严重程度的决定因素。
DOI：
10.1111/dmcn.15524
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发表时间：
2023
影响因子：
3.8
通讯作者：
Perlmutter,JoelS
中科院分区：
文献类型：
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作者：
Aravamuthan,BhoomaR;Pearson,ToniS;Ueda,Keisuke;Miao,Hanyang;Zerafati-Jahromi,Gazelle;Gilbert,Laura;Comella,Cynthia;Perlmutter,JoelS
AimTo确定运动功能管理步态肌张力障碍严重程度的专家评估的个人与脑性瘫痪（CP）MethodIn这项前瞻性队列研究中，三个运动障碍神经学家分级下肢肌张力障碍的严重程度与个人的步态视频CP使用10点李克特样量表。使用传统的内容分析，我们确定了专家在肌张力障碍严重程度分级时引用的特征。然后，使用开源姿势估计技术，我们确定了这些专家引用的功能与他们的评估肌张力障碍severity.ResultsExperts评估视频从116名参与者（46与肌张力障碍15岁[SD 3]和70没有肌张力障碍15岁[SD 2]，两组范围10-20岁，50%男性）的步态变量类似物。在识别肌张力障碍时，专家最常引用可变肢体内收，占专家陈述的60%。对步态（规律性、稳定性、轨迹、速度）和肌张力障碍幅度的影响是专家用于确定肌张力障碍严重程度的常见特征，分别占陈述的19%和13%。评估内收变异性和幅度（踝间距离方差和足内收幅度）的步态变量与肌张力障碍严重程度的专家评估显著相关（多元线性回归，p< 0.001）。解释内收变异性和幅度是可量化的步态特征，与CP患者专家确定的步态肌张力障碍严重程度相关。考虑这些特征有助于优化和标准化CP患者步态肌张力障碍严重程度的临床评估。
AimTo determine the movement features governing expert assessment of gait dystonia severity in individuals with cerebral palsy (CP).MethodIn this prospective cohort study, three movement disorder neurologists graded lower extremity dystonia severity in gait videos of individuals with CP using a 10‐point Likert‐like scale. Using conventional content analysis, we determined the features experts cited when grading dystonia severity. Then, using open‐source pose estimation techniques, we determined gait variable analogs of these expert‐cited features correlating with their assessments of dystonia severity.ResultsExperts assessed videos from 116 participants (46 with dystonia aged 15 years [SD 3] and 70 without dystonia aged 15 years [SD 2], both groups ranging 10–20 years old and 50% male). Variable limb adduction was most commonly cited by experts when identifying dystonia, comprising 60% of expert statements. Effect on gait (regularity, stability, trajectory, speed) and dystonia amplitude were common features experts used to determine dystonia severity, comprising 19% and 13% of statements respectively. Gait variables assessing adduction variability and amplitude (inter‐ankle distance variance and foot adduction amplitude) were significantly correlated with expert assessment of dystonia severity (multiple linear regression,p< 0.001).InterpretationAdduction variability and amplitude are quantifiable gait features that correlate with expert‐determined gait dystonia severity in individuals with CP. Consideration of these features could help optimize and standardize the clinical assessment of gait dystonia severity in individuals with CP.