Do Movement Deviations Influence Self-Esteem and Sense of Coherence in Mild Unilateral Cerebral Palsy?
Do Movement Deviations Influence Self-Esteem and Sense of Coherence in Mild Unilateral Cerebral Palsy?
复制标题
运动偏差是否会影响轻度单侧脑瘫患者的自尊和连贯感？
DOI：
--
复制
发表时间：
2013
期刊：
影响因子：
--
通讯作者：
A. Langius
中科院分区：
文献类型：
--
作者：
J. Riad;E. Broström;A. Langius
背景：单侧脑瘫 (CP) 患者的身体机能通常较高。尽管损伤较轻，但行走时的运动偏差往往明显不正常。在手臂中，肌张力增加会导致姿势和运动减少。在下肢，步态偏差主要涉及足部和踝部。在运动之间的过渡和快速运动期间，以及当人受到情绪影响时，这种偏差通常会变得更加明显。当个体进入青春期并变得更加自我意识时，手臂姿势和步态偏差可能被视为美容和社交障碍。目的是研究患有轻度单侧脑瘫的青少年和年轻人在行走时上肢和下肢的运动偏差对自尊和连贯感（SOC）的影响。方法：使用 8 摄像头系统进行三维步态分析。计算下肢的运动偏差、步态轮廓评分（GPS）和上肢的运动偏差以及手臂姿势评分（APS）。使用自我报告问卷“我想我是”来衡量自尊和 SOC。结果：44 名平均年龄为 17.6 岁（范围为 13.0 至 24.0 岁）的患者，其中 22 名女性和 22 名男性，以及 15 名性别匹配和年龄匹配的对照参加了该研究。 42 名患者被分类为粗大运动功能分类量表 (GMFCS) I，2 名患者被分类为 GMFCS II。患者的自尊心低于对照组（平均 63.4 比 84.7；P=0.025）。 SOC 评估显示没有差异。患者的 GPS 和 APS 分别较高（6.9 vs. 4.1；P<0.001）和（平均值，10.5 vs. 5.7；P<0.001）。 APS 与自尊（系数 -0.397；P=0.001）和 SOC（系数 -0.375；P=0.05）相关。没有发现与 GPS 的相关性。结论 尽管患有轻度单侧脑瘫的青少年和年轻人身体机能良好，但运动偏差与自尊心较低相关。随着手臂运动偏差的增加，这种情况更加明显，在评估这些人时应该考虑到这一点。证据水平：前瞻性横断面研究。三级。
Background: Individuals with unilateral cerebral palsy (CP) are often physically high functioning. Despite the mildness of the impairment, the movement deviations during walking are often noticeably deviant. In the arm, increased muscle tone causes posturing and decreased motion. In the lower extremity, gait deviations mainly involve the foot and ankle. The deviations often become more apparent with transitions between movements and during rapid movement but also when the person is emotionally affected. Arm posturing and gait deviations may be perceived as cosmetic and social impediments when the individual enters adolescence and becomes more self-conscious. The aim was to study the influence of movement deviations in the upper and lower extremity during walking, on self-esteem, and sense of coherence (SOC) in teenagers and young adults with mild unilateral CP. Methods: Three-dimensional gait analysis was performed with an 8-camera system. Movement deviations of the lower extremity, the Gait Profile Score (GPS) and of the upper extremity, and the Arm Posturing Score (APS) were calculated. Self-reported questionnaires “I think I am” measuring self-esteem and SOC were used. Results: Forty-four patients with a mean age of 17.6 years (range, 13.0 to 24.0 y), 22 females and 22 males, and 15 sex-matched and age-matched controls participated in the study. Forty-two patients were classified as Gross motor function classification scale (GMFCS) I and 2 as GMFCS II. Patients were rated with lower self-esteem than controls (mean, 63.4 vs. 84.7; P=0.025). The SOC assessments revealed no difference. The GPS and APS was higher in patients (6.9 vs. 4.1; P<0.001) and (mean, 10.5 vs. 5.7; P<0.001), respectively. The APS correlated with both self-esteem (coefficient −0.397; P=0.001) and SOC (coefficient −0.375; P=0.05). No correlations were found with the GPS. Conclusions Although physically high functioning, movement deviations in teenagers and young adults with mild unilateral CP are correlated with lower self-esteem. This is more pronounced with increased arm movement deviation and should be considered when evaluating these individuals. Level of Evidence: Prospective cross-sectional study. Level III.