痉挛型双瘫脑瘫儿童粗大运动功能与脊柱活动度的相关性

doi:10.3969/j.issn.1006-9771.2022.10.012

Abstract

Abstract:

Objective To explore the correlation between gross motor function and spinal range of motion (ROM) in children with bilateral spastic cerebral palsy.

Methods A total of 33 children with bilateral spastic cerebral palsy in Beijing Bo'ai Hospital from December, 2019 to March, 2022 were selected and divided into group 1 (grade Ⅰ, n = 12), group 2 (grade Ⅱ, n= 11) and group 3 (grade Ⅲ, n = 10) according to Gross Motor Function Classification System (GMFCS). SpinalMouse (spine morphometric machine) was used to measure the ROM of forward and backward flexion, and left and right lateral flexion of trunk, respectively, in sitting. Their gross motor ability was then further tested using the Gross Motor Function Measure (GMFM) 88 item.

Results The ROM of backward flexion, the left and right lateral flexion, and the total ROM of sagittal and coronal plane were positively correlated with the scores of GMFM88 (r > 0.424, P < 0.05), and were negatively correlated with the grade of GMFCS (|r| > 0.424, P < 0.05).

Conclusion Spinal ROM correlates with gross motor function in children with bilateral spastic cerebral palsy.

Key words: spastic, cerebral palsy, gross motor function, spine, range of motion

CLC Number:

R742.3

LI Sijia,ZHANG Qi,HE Yan,LIU Qianjin,ZHANG Yanqing,ZHOU Tiantian. Correlation between gross motor function and spinal range of motion for children with bilateral spastic cerebral palsy[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(10): 1211-1216.

Figures/Tables 5

References 35

[1]	GRAHAM H K, ROSENBAUM P, PANETH N, et al. Cerebral palsy[J]. Nat Rev Dis Primers, 2016, 2: 15082. doi: 10.1038/nrdp.2015.82 pmid: 27188686
[2]	PIERRET J, CAUDRON S, PAYSANT J, et al. Impaired postural control of axial segments in children with cerebral palsy[J]. Gait Posture, 2021, 86: 266-272. doi: 10.1016/j.gaitpost.2021.03.012 pmid: 33819768
[3]	CLOAKE T, GARDNER A. The management of scoliosis in children with cerebral palsy: a review[J]. J Spine Surg, 2016, 2(4): 299-309. doi: 10.21037/jss.2016.09.05 pmid: 28097247
[4]	PETTERSSON K, RODBY-BOUSQUET E. Prevalence and goal attainment with spinal orthoses for children with cerebral palsy[J]. J Pediatr Rehabil Med, 2019, 12(2): 197-203. doi: 10.3233/PRM-180596 pmid: 31227670
[5]	HÄGGLUND G, PETTERSSON K, CZUBA T, et al. Incidence of scoliosis in cerebral palsy[J]. Acta Orthop, 2018, 89(4): 443-447. doi: 10.1080/17453674.2018.1450091 pmid: 29537343
[6]	BERTONCELLI C M, BERTONCELLI D, ELBAUM L, et al. Validation of a clinical prediction model for the development of neuromuscular scoliosis: a multinational study[J]. Pediatr Neurol, 2018, 79: 14-20. doi: S0887-8994(17)30953-0 pmid: 29249551
[7]	HOLMES C, BROCK K, MORGAN P. Postural asymmetry in non-ambulant adults with cerebral palsy: a scoping review[J]. Disabil Rehabil, 2019, 41(9): 1079-1088. doi: 10.1080/09638288.2017.1422037 pmid: 29295638
[8]	ABD EL-NABIE W A E, SALEH M S M. Trunk and pelvic alignment in relation to postural control in children with cerebral palsy[J]. J Back Musculoskelet Rehabil, 2019, 32(1): 125-130. doi: 10.3233/BMR-181212
[9]	SEYHAN K, KEREM-GÜNEL M. Does stable sitting influence upper limb function in children with cerebral palsy?[J]. Turk J Pediatr, 2019, 61(1): 79-84.
[10]	DEUTZ U, HEUSSEN N, WEIGT-USINGER K, et al. Impact of hippotherapy on gross motor function and quality of life in children with bilateral cerebral palsy: a randomized open-label crossover study[J]. Neuropediatrics, 2018, 49(3): 185-192. doi: 10.1055/s-0038-1635121 pmid: 29486504
[11]	SAH A K, BALAJI G K, AGRAHARA S. Effects of task-oriented activities based on neurodevelopmental therapy principles on trunk control, balance, and gross motor function in children with spastic diplegic cerebral palsy: a single-blinded randomized clinical trial[J]. J Pediatr Neurosci, 2019, 14(3): 120-126. doi: 10.4103/jpn.JPN_35_19 pmid: 31649770
[12]	ILHARREBORDE B, DE SAINT ETIENNE A, PRESEDO A, et al. Spinal sagittal alignment and head control in patients with cerebral palsy[J]. J Child Orthop, 2020, 14(1): 17-23. doi: 10.1302/1863-2548.14.190160 pmid: 32165977
[13]	HASLER C, BRUNNER R, GRUNDSHTEIN A, et al. Spine deformities in patients with cerebral palsy, the role of the pelvis[J]. J Child Orthop, 2020, 14(1): 9-16. doi: 10.1302/1863-2548.14.190141
[14]	BECKUNG E, CARLSSON G, CARLSDOTTER S, et al. The natural history of gross motor development in children with cerebral palsy aged 1 to 15 years[J]. Dev Med Child Neurol, 2007, 49(10): 751-756. doi: 10.1111/j.1469-8749.2007.00751.x pmid: 17880644
[15]	HEYRMAN L, DESLOOVERE K, MOLENAERS G, et al. Clinical characteristics of impaired trunk control in children with spastic cerebral palsy[J]. Res Dev Disabil, 2013, 34(1): 327-334. doi: 10.1016/j.ridd.2012.08.015 pmid: 23000634
[16]	RODBY-BOUSQUET E, AGUSTSSON A. Postural asymmetries and assistive devices used by adults with cerebral palsy in lying, sitting, and standing[J]. Front Neurol, 2021, 12: 758706.
[17]	冯强, 周誉. 脊柱测量尺和 Spinal Mouse 脊柱测量仪测量胸椎后凸角、腰椎前凸角的信度和效度[J]. 中国运动医学杂志, 2017, 36(2): 150-155.
	FENG Q, ZHOU Y. Reliability and validity of the spinal scale and the Spinal Mouse spinal gauge in the measurement of thoracic kyphosis and lumbar lordosis[J]. Chin J Sports Med, 2017, 36(2): 150-155.
[18]	MASAKI M, OGAWA Y, INAGAKI Y, et al. Association of sagittal spinal alignment in the sitting position with the trunk and lower extremity muscle masses in children and adults with cerebral palsy: a pilot study[J]. Clin Biomech (Bristol, Avon), 2021, 90: 105491.
[19]	RUTHARD K, RAABE-OETKER A, RUTHARD J, et al. Reliability of a radiation-free, noninvasive and computer-assisted assessment of the spine in children with cerebral palsy[J]. Eur Spine J, 2020, 29(5): 937-942. doi: 10.1007/s00586-020-06328-4 pmid: 32036426
[20]	OZER KAYA D, KOCAK U Z, EMUK Y, et al. The comparison of regional spinal curvatures and movements in sitting posture in ambulatory children with cerebral palsy having minimal-to-moderate functional limitations[J]. Gait Posture, 2021, 90: 408-414. doi: 10.1016/j.gaitpost.2021.09.192 pmid: 34571351
[21]	CURTIS D J, BUTLER P, SAAVEDRA S, et al. The central role of trunk control in the gross motor function of children with cerebral palsy: a retrospective cross-sectional study[J]. Dev Med Child Neurol, 2015, 57(4): 351-357. doi: 10.1111/dmcn.12641 pmid: 25412902
[22]	MONICA S, NAYAK A, JOSHUA A M, et al. Relationship between trunk position sense and trunk control in children with spastic cerebral palsy: a cross-sectional study[J]. Rehabil Res Pract, 2021, 2021: 9758640.
[23]	SEYYAR G K, ARAS B, ARAS O. Trunk control in children with ataxic cerebral palsy[J]. Percept Mot Skills, 2019, 126(5): 815-827. doi: 10.1177/0031512519858275
[24]	YOUNG E C, HYE R J, JI H K. Comparison of trunk control on gross motor function and topography in children with spastic cerebral palsy[J]. J Korean Society Phys Med, 2019, 14(4): 45-53. doi: 10.13066/kspm.2019.14.4.45
[25]	RODBY-BOUSQUET E, HÄGGLUND G. Sitting and standing performance in a total population of children with cerebral palsy: a cross-sectional study[J]. BMC Musculoskelet Disord, 2010, 11: 131. doi: 10.1186/1471-2474-11-131
[26]	MONTERO MENDOZA S, GÓMEZ-CONESA A, HIDALGO MONTESINOS M D. Association between gross motor function and postural control in sitting in children with cerebral palsy: a correlational study in Spain[J]. BMC Pediatr, 2015, 15: 124. doi: 10.1186/s12887-015-0442-4 pmid: 26376627
[27]	DU ROSE A, BREEN A, BREEN A. Relationships between muscle electrical activity and the control of inter-vertebral motion during a forward bending task[J]. J Electromyogr Kinesiol, 2018, 43: 48-54. doi: 10.1016/j.jelekin.2018.08.004
[28]	PAVÃO S L, ROCHA N A C F. Sensory processing disorders in children with cerebral palsy[J]. Infant Behav Dev, 2017, 46: 1-6. doi: S0163-6383(15)30119-3 pmid: 27866043
[29]	GOODWORTH A, SAAVEDRA S. Postural mechanisms in moderate-to-severe cerebral palsy[J]. J Neurophysiol, 2021, 125(5): 1698-1719. doi: 10.1152/jn.00549.2020 pmid: 33788612
[30]	CARLBERG E B, HADDERS-ALGRA M. Postural dysfunction in children with cerebral palsy: some implications for therapeutic guidance[J]. Neural Plast, 2005, 12(2-3): 221-228; discussion 263-272. pmid: 16097490
[31]	STEELE K M, ROZUMALSKI A, SCHWARTZ M H. Muscle synergies and complexity of neuromuscular control during gait in cerebral palsy[J]. Dev Med Child Neurol, 2015, 57(12): 1176-1182. doi: 10.1111/dmcn.12826 pmid: 26084733
[32]	TOMITA H, FUKAYA Y, TAKAGI Y, et al. Effects of severity of gross motor disability on anticipatory postural adjustments while standing in individuals with bilateral spastic cerebral palsy[J]. Res Dev Disabil, 2016, 57: 92-101. doi: 10.1016/j.ridd.2016.06.017 pmid: 27399205
[33]	VAN BALEN L C, BOXUM A G, DIJKSTRA L J, et al. Are postural adjustments during reaching related to walking development in typically developing infants and infants at risk of cerebral palsy?[J]. Infant Behav Dev, 2018, 50: 107-115. doi: S0163-6383(17)30224-2 pmid: 29268105
[34]	汤璐. 小儿脑瘫运动功能障碍评估研究[D]. 合肥: 中国科学技术大学, 2017.
	TANG L. Evaluation of motor dysfunction in children with cerebral palsy[D]. Hefei: University of Science and Technology of China, 2017.
[35]	REDAELLI A, BERJANO P, AEBI M. Focal disorders of the spine with compensatory deformities: how to define them[J]. Eur Spine J, 2018, 27(Suppl 1): 59-69. doi: 10.1007/s00586-018-5501-8 pmid: 29383486

组别	n	性别(男/女)/n	年龄/岁	身高/m	体质量/kg	BMI/kg·m^-2
1组	12	9/3	7.33±1.77	1.23±0.16	27.95±11.5	17.50±3.38
2组	11	7/4	7.09±1.86	1.16±0.14	26.75±7.69	19.87±5.89
3组	10	6/4	7.90±2.20	1.24±0.20	25.40±9.27	15.94±2.35
F值		0.620	0.462	0.659	0.188	2.368
P值		0.733	0.635	0.524	0.829	0.111

组别	n	前屈角度	后伸角度	矢状面总活动度
1组	12	91.83±16.48	15.98±5.62	107.81±15.63
2组	11	84.67±12.49	10.42 ±4.01	95.10±14.22
3组	10	79.33±14.43	11.00±3.52	90.33±12.99
F值		2.027	5.180	4.415
P值		0.149	0.012	0.021
P值^a		0.751	0.020	0.129
P值^b		0.166	0.048	0.024
P值^c		1.000	1.000	1.000

组别	n	左屈角度	右屈角度	冠状面总活动度
1组	12	25.05(17.90,27.45)	22.60(18.10,28.68)	47.65(35.70,56.05)
2组	11	20.00(12.50,23.00)	22.00(17.00,25.40)	39.50(36.30,48.00)
3组	10	15.40(13.53,17.38)	15.00(13.30,15.70)	28.95(27.30,33.00)
H值		9.920	11.248	12.464
P值		0.007	0.004	0.002
P值^a		0.484	1.000	1.000
P值^b		0.005	0.008	0.002
P值^c		0.242	0.013	0.027

组别	n	GMFM88评分
1组	12	257.00(253.75, 258.75)
2组	11	240.00(229.00, 243.00)
3组	10	182.00(149.50, 219.00)
H值		26.840
P值		< 0.001
P值^a		0.007
P值^b		< 0.001
P值^c		0.100

脊柱活动度	GMFM88评分		GMFCS分级
脊柱活动度	r值	P值	r值	P值
前屈角度	0.342	0.051	-0.277	0.118
后伸角度	0.424	0.014	-0.424	0.014
矢状面总活动度	0.506	0.003	-0.450	0.009
左屈角度	0.575	< 0.001	-0.554	0.001
右屈角度	0.510	0.002	-0.513	0.002
冠状面总活动度	0.584	< 0.001	-0.587	< 0.001

Correlation between gross motor function and spinal range of motion for children with bilateral spastic cerebral palsy

RichHTML

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

Figures/Tables 5

References 35

Related Articles 15

Metrics

Comments

Recommended 0

[1]	HU Xiaoshi, ZHANG Qi, YUE Qing, LIANG Yanhua, LI Xiaosong, FENG Amei, ZHANG Yanqing. Effect of orthopedic elastic bandages on gait symmetry and walking ability in children with spastic hemiplegic cerebral palsy [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(9): 1083-1089.
[2]	LAN Shiling, PANG Wei, LI Xin, LIU Mengyun, ZHAN Yujun. Effect of action observation therapy on upper limb function in cerebral palsy: a systematic review [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(5): 558-564.
[3]	WANG Yongli, YU Xinchun, JIN Xinyue, BI Siyu, WANG Xi, NI Tianhao, WAN Qin, HUANG Zhaoming. Effect of speech imagery therapy on dysarthria in children with cerebral palsy [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(5): 601-607.
[4]	XU Hanlin, HU Guojiong, ZHENG Shaocheng, ZENG Xiaowen, ZENG Xianhua, SHAO Wenqi. Correlation between knee hyperextension gait and lower limb muscle activation in stroke patients with hemiplegia [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(2): 151-155.
[5]	MA Hongying, LIU Jianjun, HE Xuejin, WANG Yuxiang. Effect of rhythmic auditory stimulation on gait of patients with cerebral palsy: a systematic review [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(12): 1386-1394.
[6]	WANG Yunting, SONG Beibei, ZHAO Di, BAI Kaixiang. Health and functional outcome of whole body vibration for children and adolescents with cerebral palsy: a systematic review using WHO-FICs [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(1): 55-63.
[7]	GU Qiuyan, NI Yufei, GE Xiaoyun, WANG Feiying, LU Meijuan, XU Xiaojing. Application of pneumatic hand rehabilitation equipment in rehabilitation of hand function in children with spastic hemiplegia cerebral palsy [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(1): 93-97.
[8]	ZHU Lijie,YUN Guojun,ZHANG Weiyun,LIU Qing,CAO Jianguo. Application of ultrasonography in quantitative evaluation of gastrocnemius muscles in children with spastic cerebral palsy [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(9): 1079-1083.
[9]	LIU Peng,SU Chun,SHAO Lei,JIA Mengyi,WANG Haixia,TIAN Siyuan,GENG Kaiqing,ZHANG Yanan. Effect of modified constraint-induced movement therapy based on Chinese version of Quality of Upper Extremity Skills Test on upper limb function for children with hemiplegic cerebral palsy [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(8): 897-902.
[10]	ZHANG Wenbo,QU Chang,ZHOU Jianping,ZHANG Xiaoping,ZHANG Xiaotian. Wrist joint range of motion measurement based on Azure Kinect bone tracking [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(8): 981-988.
[11]	GE Shengnan,WANG Yongli,YIN Minmin,WAN Qin,YANG Yaru,Lancy Lantin HUANG,HUANG Zhaoming. Diagnosis, assessment and rehabilitation of speech disorders after cerebral palsy using WHO-FICs [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(6): 637-645.
[12]	TIAN Yaxing,HONG Yongfeng,KAN Xiuli,SHEN Xianshan,MAO Jing,JIANG Yan,HE Ziyan,WU Yu,HU Wei,SUN Xiaoning,HU Shunyin. Effects of manual digitorum sensory stimulation on spasticity of fingers for stroke patients: a surface electromyography study [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(5): 515-519.
[13]	YU Xinlu, LI Xin, YANG Tingting, ZHANG Bo, FENG Yuxia, PANG Wei. Application of sensory integration therapy in cerebral palsy rehabilitation: a systematic review [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(2): 183-189.
[14]	HE Ziyan,TANG Xiaoxiao,TIAN Yaxing,JIANG Fan,KAN Xiuli,SHEN Xianshan,MAO Jing,XU Jun,LIU Xue,WU Jianxian,WU Tingting,HONG Yongfeng. Features in digitorum muscular tension and shear-wave elastography in hemiplegic patients with stroke before and after manual digitorum sensory stimulation [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(2): 204-211.
[15]	GUO Jingwei,GE Ruidong,BAI Shuo,WANG Jiaxi,WU Shuai,WANG Le. Characteristics of surface electromyography of muscles in stroke patients with lower limb spasticity under isokinetic passive movement [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(12): 1473-1477.