在对脑瘫儿童肌张力障碍的严重程度进行分级时，上肢运动学分析优于肌电图分析

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2024-07-01 DOI:10.1016/j.clinbiomech.2024.106295

Melissa Gar Yee Louey , Adrienne Harvey , Elyse Passmore , David Grayden , Morgan Sangeux

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引用次数: 0

摘要

背景脑性瘫痪儿童运动障碍的严重程度通常通过基于观察的临床工具进行评估。为了提高评估的准确性和可靠性，有人提出了客观测量运动障碍的仪器方法。在此，我们研究了最适合客观测量脑瘫儿童肌张力障碍严重程度的技术和运动特征。方法我们对 12 名上肢受累的脑瘫患者（平均年龄：12.6 岁，范围：6.7-18.2 岁）进行了前瞻性观察研究，这些患者的主要运动类型为肌张力障碍、痉挛或肌张力障碍/痉挛混合型。在进行三项上肢任务时，收集了双侧的运动学和肌电图数据。通过运动障碍损害量表计算运动学或肌电图特征与肌张力障碍严重程度的斯皮尔曼等级相关性。研究结果与肌电图特征相比，运动学特征对脑瘫儿童肌张力障碍严重程度的分级更具影响力。这项研究为客观测量脑瘫儿童肌张力障碍严重程度时，仪器测量方法应关注的数据类型、运动特征和活动方案提供了指导。

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Kinematic upper limb analysis outperforms electromyography at grading the severity of dystonia in children with cerebral palsy

Background

Severity of dyskinesia in children with cerebral palsy is often assessed using observation-based clinical tools. Instrumented methods to objectively measure dyskinesia have been proposed to improve assessment accuracy and reliability. Here, we investigated the technique and movement features that were most suitable to objectively measure the severity of dystonia in children with cerebral palsy.

Methods

A prospective observational study was conducted with 12 participants with cerebral palsy with a predominant motor type of dyskinesia, spasticity, or mixed dyskinesia/spasticity who had upper limb involvement (mean age: 12.6 years, range: 6.7–18.2 years). Kinematic and electromyography data were collected bilaterally during three upper limb tasks. Spearman rank correlations of kinematic or electromyography features were calculated against dystonia severity, quantified by the Dyskinesia Impairment Scale.

Findings

Kinematic features were more influential compared to electromyography features at grading the severity of dystonia in children with cerebral palsy. Kinematic measures quantifying jerkiness of volitional movement during an upper limb task with a reaching component performed best (|r_s| = 0.78–0.9, p < 0.001).

Interpretation

This study provides guidance on the types of data, features of movement, and activity protocols that instrumented methods should focus on when objectively measuring the severity of dystonia in children with cerebral palsy.

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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.