北京生物医学工程

痉挛型脑瘫儿童动态足底压力分布特征研究

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

作者：王雪森闫松华郑华付晓虎孔繁闰王启宁张宽

单位：首都医科大学生物医学工程学院（北京 100069）首都医科大学临床生物力学应用基础研究北京市重点实验室（北京 100069）首都医科大学附属北京儿童医院康复科（北京100045）北京大学工学院（北京100871）

关键词：痉挛型脑瘫儿童；足底压力分布；步态测试；受累侧；非受累侧

分类号：R318.01

出版年·卷·期（页码）：2019·38·1（28-35）

摘要：

目的量化分析痉挛型脑瘫儿童足底压力分布特征，为临床诊断提供参考。方法选取12名GMFCSⅠ级或Ⅱ级的痉挛型脑瘫儿童和16名正常儿童作为研究对象，应用0.5 m足底压力分布测试系统（Rsscan International@, 比利时）对受试者进行自然行走过程的步态测试，采用独立样本t检验和配对t检验分别对脑瘫儿童和正常儿童及脑瘫儿童患侧、健侧步态参数的差异性进行检验。结果痉挛型脑瘫儿童足跟着地期、足后部所受冲量百分比、足中部和足跟中部压强峰值、第一趾骨和第一跖骨单位时间负荷率显著小于健康儿童（P<0.001、P=0.029、P=0.035、P=0.027、P=0.017、P=0.026），而全足支撑期、足中部所受冲量百分比、足弓指数、足底第三到第五跖骨和足中部所受冲量显著大于健康儿童（P=0.041、P=0.031、P=0.034、P=0.024、P=0.007、P=0.045、P=0.046）；痉挛型脑瘫儿童受累侧和非受累侧差异无统计学意义。结论痉挛型脑瘫儿童行走过程中足底压力特征发生明显改变，并且非受累侧存在代偿作用。本研究对痉挛型脑瘫儿童足底压力特征进行了量化分析，为医生的诊断提供量化参考。

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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