Spastic diparetic does not directly affect the capacity to ascend and descend access ramps: three-dimensional analysis
Spastic diparetic does not directly affect the capacity to ascend and descend access ramps: three-dimensional analysis
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DOI：
10.1590/1980-5918.030.003.ao12
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发表时间：
2017-09-01
影响因子：
--
通讯作者：
Israel, Vera Lúcia
中科院分区：
文献类型：
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作者：
Mélo, Tainá Ribas;Guimarães, Ana Tereza Bittencourt;Israel, Vera Lúcia
摘要 简介：双瘫儿童存在步态困难，因此坡道被用作无障碍策略。 目的：本研究调查了与正常发育的对照组（CG）儿童相比，倾斜表面（上升和下降）对双瘫组（DG）步态运动学特征的影响。 方法：研究参与者包括年龄匹配的 20 名儿童（10 名 DG 和 10 CG），通过光电成像系统在三种实验条件（水平、倾斜上升和倾斜下降表面 7°）下对其进行评估。 结果：在线性运动学变量中，组间仅步长不同，但不受表面影响。各组的足部高度仅在下降阶段存在差异，其中 DG 抬起足部的困难更大。 3维步态分析无法提供更多证据证明DG和CG之间的运动学变量差异，特别是在横向平面上，但提供了一些证据来支持步态周期期间的髋关节运动范围（ROM）、初始接触时的髋关节屈伸、膝关节ROM和DG的第二前后躯干峰值幅度在下降时受到屈肌模式的影响。 结论：DG 比 CG 受倾斜面的影响最大，特别是在下降时。尽管 DG 在 7° 倾斜时髋部和膝部屈肌模式很明显，但该角度是可以实现的，因为它允许独立的步态功能活动。
Abstract Introduction: Diplegic children have difficulties in gait and therefore ramps are used as strategies of accessibility. Objective: The present study investigated the influence of an inclined surface (ascending and descending) on the kinematic characteristics during gait of the diplegic group (DG) when compared to typically developing children of the control group (CG). Methods: Study participants included 20 children (10 with DG and 10 CG) matched by age, which were evaluated in three experimental conditions (horizontal and inclined ascending and inclined descending surfaces of 7º) through an optoelectronic imaging system. Results: Among the linear kinematic variables, only step width differed among groups, however, without influence of the surface. The foot height differed among the groups only in the descending phase, where DG had greater difficulty in raising the foot. The 3-dimensional gait analyses could not provide more evidences of differences in kinematics variables, especially in transverse plane, between DG and CG, but provide some evidence to support that hip range of motion (ROM) during the gait cycle, hip flexion-extension in initial contact, knee ROM and the 2nd anterior-posterior trunk peak amplitude of the DG were influenced on descent by their flexor pattern. Conclusion: The DG was most affected by the inclination plane than CG especially on descent. Although a hip and knee flexor pattern is evident for DG on inclination of 7º, this angle is accessible since it allows independent gait functional activity.