Achilles tendon moment arm length is smaller in children with cerebral palsy than in typically developing children
Achilles tendon moment arm length is smaller in children with cerebral palsy than in typically developing children
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DOI：
10.1016/j.jbiomech.2017.02.027
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发表时间：
2017-05-03
影响因子：
2.4
通讯作者：
O'Brien, Thomas D.
中科院分区：
文献类型：
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作者：
Kalkman, Barbara M.;Bar-On, Lynn;O'Brien, Thomas D.
当研究脑瘫儿童的肌肉和全身功能时，关于内外力矩臂的知识是必不可少的，因为它们决定了肌肉相对于外力的机械优势。在这里，我们询问跟腱力矩臂（MA(AT)）长度在CP儿童和年龄匹配的典型发育（TD）儿童中是否不同，以及MA（AT）是否可以通过人体测量来预测。16例CP患儿（年龄：10y - 7米+/- 3岁，7例偏瘫，12例双瘫，GMFCS等级：I（11）和II(8)）和20例TD患儿（年龄：10y - 6米+/- 3岁）参与病例对照研究。通过区分跟骨位移相对于踝关节角度，计算跖屈20（圆）时的MA（AT）。测量了与MA（AT）相关的7个人体测量变量。我们发现，与TD儿童相比，CP儿童的标准化MA（AT）小15%（约7 mm） （p = 0.003）。MA（AT）可以通过胫骨长度的所有人体测量来预测，分别解释了CP和TD儿童中79%和72%的方差。我们的研究结果对临床决策具有重要意义，因为MA（AT）影响踝关节的机械优势，这有助于运动功能，并可通过手术操作。(C) 2017 Elsevier Ltd.版权所有。
When studying muscle and whole-body function in children with cerebral palsy (CP), knowledge about both internal and external moment arms is essential since they determine the mechanical advantage of a muscle over an external force. Here we asked if Achilles tendon moment arm (MA(AT)) length is different in children with CP and age-matched typically developing (TD) children, and if MA(AT) can be predicted from anthropometric measurements. Sixteen children with CP (age: 10y 7 m +/- 3y, 7 hemiplegia, 12 diplegia, GMFCS level: I (11) and II (8)) and twenty TD children (age: 10y 6 m +/- 3y) participated in this case control study. MA(AT) was calculated at 20(circle) plantarflexion by differentiating calcaneus displacement with respect to ankle angle. Seven anthropometric variables were measured and related to MA(AT). We found normalized MA(AT) to be 15% (similar to 7 mm) smaller in children with CP compared to TD children (p = 0.003). MA(AT) could be predicted by all anthropometric measurements with tibia length explaining 79% and 72% of variance in children with CP and TD children, respectively. Our findings have important implications for clinical decision making since MA(AT) influences the mechanical advantage about the ankle, which contributes to movement function and is manipulated surgically. (C) 2017 Elsevier Ltd. All rights reserved.