足底压力式步态分析中痉挛型脑瘫儿童的平衡能力特征

目的:临床上坐位、站立位的平衡测试常利用平衡仪来进行,但由于平衡仪足踏板的限制,无法对脑性瘫痪(脑瘫)患儿步行时动态连续步行周期的平衡能力进行测试.文章利用足底压力式步态分析技术,观察痉挛型脑瘫儿童步行时在平衡能力方面的特征.方法:选择具有正常步行能力的健康儿毫78例作为正常儿童组,另外选择2004 05/2007-05在深圳市儿童医院康复科日间病房住院治疗的脑瘫患儿25例作为脑瘫儿童组.利用足底压力式步态分析系统,对2组对象分别进行足底压力式步态分析,记录2组儿童步行时的足底压力数据.观测指标分为量化指标和直观压力图.量化指标包括步频、步态周期时间、步态周期各时相的绝对对称性指标等参数.直观压力图包括动态足底压力图以及足底压力重心偏移轨迹图.结果:与正常儿童组相比,脑瘫儿童组步频较小,步态周期时间较长(P<0.01).脑瘫儿童组单足支撑期、摆动期、双足支撑期、步态周期时间的绝对对称性指标均大于正常儿童组(P<0.05).脑瘫儿童步行时双足的足底压力图的对称性、重复性较正常儿童差;重心偏移轨迹图不能形成左右对称的蝴蝶状图形.结论:痉挛型脑瘫儿童步行时,步态周期各时相均存在对称性下降的情况.足底压力式步态分析技术能有效地应用于痉挛型脑瘫儿童步态的平衡能力评估.

Balancing characteristics of children with spastic cerebral palsy during gait measurement using plantar pressure gait analysis system

OBJECTIVE: Usually, the balance tests of sitting and standing position are performed by balancing instruments clinicalty, but because of the restriction of foot pedal, this kind of instruments cannot measure balancing ability in continuous dynamic gait cycles in gait of cerebral palsy children. Using plantar pressure gait analysis system, this study sought to study balance characteristics in gait of children with spastic cerebral palsy.METHODS: A total of 78 healthy children served as normal control group, and 25 children with spastic cerebral palsy as cerebral palsy group at the Department of Rehabilitation, Shenzhen Children's Hospital from May 2004 to May 2007. A plantar pressure gait analysis system was used to perform plantar pressure gait analysis tests of children in both groups. All plantar pressure data of both groups was recorded. Main outcome measures contained quantized data including cadence, cycle time of gait, absolute symmetry index (ASI) of each gait phase, and visualized pressure diagram including dynamic plantar pressure diagram and center of Gravity's transfer track diagram.RESULTS: Comparing with normal control group, children of cerebral palsy group had fewer cadences and longer gait cycle time in gait (P<0.01). ASI of single-foot supporting phase, swing phase, double-foot supporting phase and gait cycle time of cerebral palsy group were higher than normal control group (P<0.05). Symmetry and repeatability of plantar pressure diagram of both feet were poorer than normal control group. Center of Gravity's transfer track diagram could not show as butterfly-shape graphics with good symmetry.CONCLUSION: ASI of each phase of gait cycle of spastic CP children increased significantly in gait. Plantar pressure gait analysis technology can be effectively applied to evaluate the balancing ability of children with spastic cerebral palsy in gait.