Influence of musculoskeletal pain during gait on kinematics and selective motor control in individuals with spastic cerebral palsy: A pilot study

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2024-03-01 DOI:10.1016/j.clinbiomech.2024.106219

Gilad Sorek , Marije Goudriaan , Itai Schurr , Simon-Henri Schless

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引用次数: 0

Abstract

Background

Individuals with cerebral-palsy commonly present with altered kinematics and selective-motor-control during gait, and may also experience musculoskeletal pain. This pilot study aims to investigate if the immediate experience of musculoskeletal pain during gait influences kinematics and selective-motor-control in individuals with spastic cerebral-palsy.

Methods

Retrospective treadmill-based gait-analysis data for 145 individuals with spastic cerebral-palsy were screened. Participants were asked about experiencing lower-extremity musculoskeletal pain immediately during gait, with 26 individuals (18%) reporting this was the case (pain-group; mean 11.55 ± 3.15 years, Gross-Motor-Function-Classification-System levels I/II/III n = 5/13/8, Uni/bilateral involvement n = 11/15). Of the 77 individuals who did not report any pain, a no-pain group (n = 26) was individually matched. Kinematics were evaluated using the Gait-Profile-Score and spatiotemporal parameters (dimensionless-walking-speed, single-leg-support percentage and step-time). Selective-motor-control was assessed using the Walking-Dynamic-Motor-Control index.

Findings

In the pain-group, 58% reported experiencing pain in their more-involved leg, 8% in the less-involved leg and 34% in both legs. Regarding the pain location, 38% of the pain-group reported experiencing pain in multiple locations. On a more specific level, 35%, 46% and 54% reported pain around the hip/thigh, knee/calf and ankle/ft, respectively. No significant differences were observed between the pain and no-pain groups for any of the outcome measures, in each leg or bilaterally.

Interpretation

No significant differences in kinematics and selective-motor-control during gait were found between individuals with spastic cerebral-palsy, with and without musculoskeletal pain. This suggests that the individuals in this study may not present with obvious antalgic gait patterns, which may relate to the pre-existing altered kinematics and selective-motor-control.

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步态过程中的肌肉骨骼疼痛对痉挛性脑瘫患者运动学和选择性运动控制的影响：试点研究

脑性瘫痪患者在步态过程中通常会出现运动学和选择性运动控制的改变，同时还可能出现肌肉骨骼疼痛。本试验性研究旨在探讨步态过程中肌肉骨骼疼痛的直接体验是否会影响痉挛性脑瘫患者的运动学和选择性运动控制。研究人员筛选了 145 名痉挛性脑瘫患者的基于跑步机的步态分析数据。参与者被问及在步态过程中是否会立即感到下肢肌肉骨骼疼痛，有 26 人（18%）报告了这种情况（疼痛组；平均 11.55 ± 3.15 岁，粗大运动功能分类系统 I/II/III 级 = 5/13/8，单侧/双侧受累 = 11/15）。在 77 名未报告任何疼痛的患者中，无疼痛组（= 26）进行了单独配对。运动学评估采用步态轮廓评分和时空参数（无量纲行走速度、单腿支撑百分比和步长）。选择性运动控制采用步行动态运动控制指数进行评估。在疼痛组中，有 58% 的人表示疼痛发生在受累较多的腿上，8% 的人表示疼痛发生在受累较少的腿上，34% 的人表示疼痛发生在两条腿上。在疼痛部位方面，38% 的疼痛组患者表示在多个部位感到疼痛。从更具体的角度看，分别有 35%、46% 和 54% 的人报告在臀部/大腿、膝盖/小腿和脚踝/脚掌周围感到疼痛。在每条腿或双侧的任何结果测量中，疼痛组和无疼痛组之间均未观察到明显差异。有和没有肌肉骨骼疼痛的痉挛性脑瘫患者在步态运动学和选择性运动控制方面没有发现明显差异。这表明，本研究中的患者可能并不表现出明显的反步态模式，这可能与之前存在的运动学和选择性运动控制的改变有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Biomechanics 医学-工程：生物医学

CiteScore

3.30

自引率

5.60%

发文量

189

审稿时长

12.3 weeks

期刊介绍： Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field. The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and technologies. Clinical Biomechanics aims to strengthen the links between laboratory and clinic by publishing cutting-edge biomechanics research which helps to explain the causes of injury and disease, and which provides evidence contributing to improved clinical management. A rigorous peer review system is employed and every attempt is made to process and publish top-quality papers promptly. Clinical Biomechanics explores all facets of body system, organ, tissue and cell biomechanics, with an emphasis on medical and clinical applications of the basic science aspects. The role of basic science is therefore recognized in a medical or clinical context. The readership of the journal closely reflects its multi-disciplinary contents, being a balance of scientists, engineers and clinicians. The contents are in the form of research papers, brief reports, review papers and correspondence, whilst special interest issues and supplements are published from time to time. Disciplines covered include biomechanics and mechanobiology at all scales, bioengineering and use of tissue engineering and biomaterials for clinical applications, biophysics, as well as biomechanical aspects of medical robotics, ergonomics, physical and occupational therapeutics and rehabilitation.