A descriptive analysis of the upper limb patterns during gait in individuals with cerebral palsy
A descriptive analysis of the upper limb patterns during gait in individuals with cerebral palsy
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DOI：
10.1016/j.ridd.2014.07.013
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发表时间：
2014-11-01
影响因子：
3.1
通讯作者：
Armand, S.
中科院分区：
文献类型：
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作者：
Bonnefoy-Mazure, A.;Sagawa, Y., Jr.;Armand, S.
脑性瘫痪（CP）患者的特点是步态偏差的多样性很大，因此，在步态下肢运动已在文献中进行了充分的分析。然而，对于CP患者来说，上肢运动问题，更具体地说，步态期间手臂运动的问题，作为疾病类型（半身不遂，HE或双瘫，DI）的函数，受到的关注较少。因此，本研究的目的是调查一大组CP患者的上肢运动;我们使用回顾性检索，包括上肢运动学参数和92例CP患者（42例女性和50例男性，平均标准差（SD）;年龄：15.2 ± 6.7岁）。其中HE 48例，DI 44例。研究中纳入了15例受试者（7例女性和8例男性，年龄：18.4 ± 8.4岁）的对照组，以提供正常步态数据。对于DI患者和CG，分别分析了88个组和30个组。对于HE患者，分析了48个受累手臂和48个非受累手臂。选择和分析的运动学参数是肩仰角;肘屈曲角;胸部倾斜和弯曲角;手垂直和前后运动;和手臂角度。还分析了几个步态参数，例如步态轮廓评分（GPS）和标准化速度。进行统计分析，比较CG与HE患者的受累和非受累上肢以及DI患者的两个上肢。结果表明，HE和DI患者上肢运动异常。然而，与HE患者相比，DI患者的肩、肘、胸和臂角度运动更大。然而，HE患者采用不同的运动之间的影响和非影响的手臂。因此，患者在步态偏差更重要的情况下更多地使用上肢来优化步态。这些观察结果证实，上肢必须纳入康复计划，以提高肢体间的协调。(C)2014爱思唯尔有限公司版权所有。
Patients with cerebral palsy (CP) are characterized by a large diversity of gait deviations; thus, lower limb movements during gait have been well-analyzed in the literature. However, the question of upper limb movements and, more particularly, arm movements during gait has received less attention for CP patients as a function of the disease type (Hemiplegic, HE or Diplegic, DI). Thus, the aim of this study was to investigate upper limb movements for a large group of CP patients; we used a retrospective search, including upper limb kinematic parameters and 92 CP patients (42 females and 50 males, mean standard deviation (SD); age: 15.2 +/- 6.7 years). The diagnoses consisted of 48 HE and 44 DI. A control group of 15 subjects (7 females and 8 males, age: 18.4 +/- 8.4 years) was included in the study to provide normal gait data. For the DI patients and CG, 88 arms and 30 arms were analyzed, respectively. For the HE patients, 48 affected arms and 48 non-affected arms were analyzed. The kinematic parameters selected and analyzed were shoulder elevation angles; elbow flexion angles; thorax tilt and obliquity angles; hand vertical and anterior-posterior movements; and arm angles. Several gait parameters were also analyzed, such as the gait profile score (GPS) and normalized speed. Statistical analyses were performed to compare CG with the affected and non-affected upper limbs of HE patients and with the two upper limbs of DI patients. The results show that HE and DI patients adopt abnormal upper limb movements. However, DI patients have greater shoulder, elbow, thorax and arm angle movements compared with HE patients. However, HE patients adopt different movements between their affected and non-affected arms. Thus, the patients used their upper limbs to optimize their gait more where gait deviations were more important. These observations confirm that the upper limbs must be integrated into rehabilitation programs to improve inter-limb coordination. (C) 2014 Elsevier Ltd. All rights reserved.