Ankle dorsiflexion fMRI in children with cerebral palsy undergoing intensive body-weight-supported treadmill training: a pilot study

Ankle dorsiflexion fMRI in children with cerebral palsy undergoing intensive body-weight-supported treadmill training: a pilot study
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DOI:
10.1017/s0012162207000102
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发表时间:
2007-01-01
影响因子:
3.8
通讯作者:
Bernitsky-Beddingfield, Ann
Bernitsky-Beddingfield, Ann
中科院分区:
医学2区
文献类型:
--
作者:
Phillips, John P.;Sullivan, Katherine J.;Bernitsky-Beddingfield, Ann

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这项初步研究探讨了脑性瘫痪(CP)儿童在高强度体重支持跑步机训练(BWSTT)前后使用功能磁共振成像(FMRI)作为脑可塑性的生理标记物的可行性。6例痉挛型脑瘫(偏瘫4例,非对称性双瘫2例,均为粗大运动功能分级1级)患儿(男4例,女2例;平均年龄10岁6个月,年龄6~14岁)接受BWSTT治疗,每日2次,疗程2周。AD儿童耐受治疗;只有一次治疗因疲劳而中止。训练后地面平均步行速度由训练前的1.47m/S提高到1.66m/d(P=0.035)。步行6min的距离无变化(前451米;后458米,P=0.851)。在三名儿童中,在干预前和干预后进行了可靠的皮质激活FMRI检查。在干预后,所有三名儿童在踝关节背屈时的皮质激活均有增加。这项研究表明,患有脑性瘫痪的6至14岁的儿童可以耐受高强度的运动训练,并且经过适当的修改,可以完成一系列的fMRI。这项研究支持了进一步的研究,旨在调查患有脑瘫的儿童的训练依赖性可塑性。
This pilot study investigated the feasibility of using functional magnetic resonance imaging (fMRI) as a physiological marker of brain plasticity before and after an intensive body-weight-supported treadmill training (BWSTT) program in children with cerebral palsy (CP). Six ambulatory children (four males, two females; mean age 10y 6mo, age range 6-14y) with spastic CP (four hemiplegia, two asymmetric diplegia, all Gross Motor Function Classification System Level 1) received BWSTT twice daily for 2 weeks. AD children tolerated therapy; only one therapy session was aborted due to fatigue. With training, over-ground mean walking speed increased from 1.47 to 1.66m/s (P=0.035). There was no change in distance walked for 6 minutes (pre-: 451m; post-: 458m;p=0.851). In three children, reliable fMRIs were taken of cortical activation pre- and post-intervention. Post-intervention increases in cortical activation during ankle dorsiflexion were observed in all three children. This study demonstrates that children with CP between 6 and 14 years of age can tolerate intensive locomotor training and, with appropriate modifications, can complete an fMRI series. This study supports further studies designed to investigate training-dependent plasticity in children with CP.