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目的:对痉挛性脑瘫患儿与正常儿童起步过程步态的生物力学参数进行分析,为痉挛性脑瘫患儿步行能力的评价提供参考。方法:采用三维运动捕捉系统和测力台,运用分析软件采集观察组28例痉挛性脑瘫患儿和对照组24例正常儿童起步过程时-空、运动学和动力学数据。时空参数包括第一步步长、第一步时间、双支撑时间、第一步步速;运动学参数包括膝、踝关节活动度;动力学参数包括向前动量和垂直轴、额状轴及矢状轴地面反力峰值。采用独立样本均数t检验比较两组各参数的差异。结果:(1)起步过程中两组时-空各参数均有显著性差异(P<0.05)。(2)起步过程中两组运动学参数支撑脚踝关节活动度有显著性差异(P<0.05)。(3)除右脚为起步脚的额状轴GRFs峰值外,起步过程中两组其余动力学参数均有显著性差异(P<0.05)。结论:起步过程的时-空各参数、支撑脚踝关节活动度、动力学各参数的分析对痉挛性脑瘫患儿步行能力的评价有一定参考价值。
OBJECTIVE: To analyze the biomechanical parameters of gait in children with spastic cerebral palsy and normal children and to provide a reference for the evaluation of walking ability in children with spastic cerebral palsy. Methods: Three-dimensional motion capture system and force-measuring platform were used to analyze the spatial-temporal, kinematic and kinetic data of 28 normal children with spastic cerebral palsy in the observation group and 24 normal children in the observation group. Time and space parameters include the first step, the first step time, double support time, the first step speed; kinematics parameters including knee and ankle joint activity; kinetic parameters include forward momentum and vertical axis, the amount of axis and Sagittal axis of the ground reaction peak. The independent sample mean t-test was used to compare the differences between the two groups of parameters. Results: (1) The time-space parameters of two groups had significant difference (P <0.05). (2) There was a significant difference in the activities of ankle between the two groups in starting kinematics parameters (P <0.05). (3) There was a significant difference (P <0.05) between the rest kinetic parameters of the two groups except for the peak of the frontal axis GRFs of the starting foot in the right foot. CONCLUSION: The time-space parameters of the starting process, the degree of supportive ankle joint mobility and the analysis of kinetic parameters have some reference value for the evaluation of walking ability of children with spastic cerebral palsy.