北京生物醫(yī)學(xué)工程

痙攣型腦癱兒童動(dòng)態(tài)足底壓力分布特征研究

Characteristics of dynamic plantar pressure during walking in children with spastic cerebral palsy

作者：王雪森閆松華鄭華付曉虎孔繁閏王啟寧張寬

單位：首都醫(yī)科大學(xué)生物醫(yī)學(xué)工程學(xué)院（北京 100069）首都醫(yī)科大學(xué)臨床生物力學(xué)應(yīng)用基礎(chǔ)研究北京市重點(diǎn)實(shí)驗(yàn)室（北京 100069）首都醫(yī)科大學(xué)附屬北京兒童醫(yī)院康復(fù)科（北京100045）北京大學(xué)工學(xué)院（北京100871）

關(guān)鍵詞：痙攣型腦癱兒童；足底壓力分布；步態(tài)測(cè)試；受累側(cè)；非受累側(cè)

分類(lèi)號(hào)：R318.01

出版年·卷·期（頁(yè)碼）：2019·38·1（28-35）

摘要：

目的量化分析痙攣型腦癱兒童足底壓力分布特征，為臨床診斷提供參考。方法選取12名GMFCSⅠ級(jí)或Ⅱ級(jí)的痙攣型腦癱兒童和16名正常兒童作為研究對(duì)象，應(yīng)用0.5 m足底壓力分布測(cè)試系統(tǒng)（Rsscan International@, 比利時(shí)）對(duì)受試者進(jìn)行自然行走過(guò)程的步態(tài)測(cè)試，采用獨(dú)立樣本t檢驗(yàn)和配對(duì)t檢驗(yàn)分別對(duì)腦癱兒童和正常兒童及腦癱兒童患側(cè)、健側(cè)步態(tài)參數(shù)的差異性進(jìn)行檢驗(yàn)。結(jié)果痙攣型腦癱兒童足跟著地期、足后部所受沖量百分比、足中部和足跟中部壓強(qiáng)峰值、第一趾骨和第一跖骨單位時(shí)間負(fù)荷率顯著小于健康兒童（P<0.001、P=0.029、P=0.035、P=0.027、P=0.017、P=0.026），而全足支撐期、足中部所受沖量百分比、足弓指數(shù)、足底第三到第五跖骨和足中部所受沖量顯著大于健康兒童（P=0.041、P=0.031、P=0.034、P=0.024、P=0.007、P=0.045、P=0.046）；痙攣型腦癱兒童受累側(cè)和非受累側(cè)差異無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論痙攣型腦癱兒童行走過(guò)程中足底壓力特征發(fā)生明顯改變，并且非受累側(cè)存在代償作用。本研究對(duì)痙攣型腦癱兒童足底壓力特征進(jìn)行了量化分析，為醫(yī)生的診斷提供量化參考。

Objective Quantitative analysis of the distribution of plantar pressure in children with spastic cerebral palsy can provide reference for clinical diagnosis. Methods 12 children with spastic cerebral palsy of GMFCSⅠ or Ⅱ and 16 healthy children were chosen as subjects. The gaits of the subjects during the natural walking were tested using 0.5 m Footscan system (Rsscan International@, Belgium). The differences of gait parameters between the affected and healthy sides of cerebral palsy children were examined by paired t test, the differences of gait parameters between normal children and cerebral palsy children were examined by independent sample t test. Results During walking, children with spastic cerebral palsy had significantly shorter period of heel strike, Impulse percentage of rear foot, peak pressures under midfoot(MF) and heel medial(HL), load rates under Toe1（T1）and Meta 1(M1) compared to healthy children(P<0.001，P=0.029，P=0.035，P=0.027，P=0.017，P=0.026). The period of full foot support, impulse percentage under midfoot, foot arch index, load rates under toe1（T1）, meta 1(M1), meta 3-5(M3-5) and midfoot(MF) are significantly higher than healthy children（P=0.041，P=0.031，P=0.034，P=0.024，P=0.007，P=0.045，P=0.046).There were no significant differences for plantar pressure distribution parameters between affected side and non-affected side in children with spastic cerebral palsy. Conclusions The characteristics of the plantar pressure distribution in the children with spastic cerebral palsy are changed significantly compared to normal chidlren, and there is a compensatory role on the non affected side. This study quantifies the characteristics of the plantar pressure distribution in children with spastic cerebral palsy and provides a quantitative reference for the doctor.

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