CAJ | 학술논문

目的探讨基于三维步态分析(3DGA)的个性化康复治疗对痉挛型脑性瘫痪(脑瘫)患儿步行功能的影响.方法选择痉挛型双瘫或偏瘫的脑瘫患儿21例,IQ＞60分,平均年龄(8.1±3.3)岁.所有患儿治疗前均接受3DGA,并根据分析结果制订个性化康复治疗方案,于治疗4周后(治疗后)再次接受3DGA,并比较治疗前、后的步行参数.结果治疗后,脑瘫患儿的足背屈角度、腘窝角度、步行中步速、步长、跨步长、支撑相初期踝关节最大背屈角度、支撑相末期踝关节最大跖屈角度、最大后向地面反作用力及最大垂直地面反作用力较治疗前均明显改善,差异有统计学意义(P＜0.05)；步频、总支撑时间、初始双支撑时间、摆动相时间、支撑相中期膝关节最大伸展角度及最大前向地面反作用力与治疗前比较无明显改变,差异无统计学意义(P＞0.05).结论痉挛型脑瘫患儿经3DGA指导下的个性化康复治疗可显著改善痉挛型脑瘫患儿的步行功能,且3DGA对脑瘫患儿个性化康复治疗方案的制定及修改有重要的指导作用.
목적 탐토기우삼유보태분석(3DGA)적개성화강복치료대경련형뇌성탄탄(뇌탄)환인보행공능적영향.방법 선택경련형쌍탄혹편탄적뇌탄환인21례,IQ＞60분,평균년령(8.1±3.3)세.소유환인치료전균접수3DGA,병근거분석결과제정개성화강복치료방안,우치료4주후(치료후)재차접수3DGA,병비교치료전、후적보행삼수.결과 치료후,뇌탄환인적족배굴각도、객와각도、보행중보속、보장、과보장、지탱상초기과관절최대배굴각도、지탱상말기과관절최대척굴각도、최대후향지면반작용력급최대수직지면반작용력교치료전균명현개선,차이유통계학의의(P＜0.05)；보빈、총지탱시간、초시쌍지탱시간、파동상시간、지탱상중기슬관절최대신전각도급최대전향지면반작용력여치료전비교무명현개변,차이무통계학의의(P＞0.05).결론 경련형뇌탄환인경3DGA지도하적개성화강복치료가현저개선경련형뇌탄환인적보행공능,차3DGA대뇌탄환인개성화강복치료방안적제정급수개유중요적지도작용.
Objective To study the effectiveness of personalized rehabilitation treatments based on threedimensional gait analysis (3DGA) for improving the walking function of children with cerebral palsy (CP).Methods A total of 21 spastic CP children with diplegia or hemiplegia,IQ scores ＞60,and an average age of 8.5 years received 3DGA.They then received personalized rehabilitation treatment designed according to the 3DGA results.After four weeks of treatment the children accepted 3DGA again.Their gait descriptors before and after treatment were compared. Results After the personalized rehabilitation the subjects'clinical foot dorsiflexion angle,clinical popliteal fossa angle,walking velocity,stride length,step length,peak ankle dorsiflexion in prime stance,peaking ankle plantar flexion in last stance,peak back ground reaction forces (GRFs) and peak vertical GRF in stance all had improved significantly.The cadence,total support time,swing phase,initial double support time,peak knee extension in stance and the peak forward GRF were not,however,significantly different compared with before the personalized rehabilitation treatment. Conclusion Under the guidance of 3DGA,the walking function of spastic CP children improved significantly after 4 weeks of personalized rehabilitation treatment.3DGA can play an important role in formulating personalized rehabilitation protocols and guiding rehabilitation treatment for CP children.