不同程度新生儿臂丛神经麻痹患者的上肢运动学分析。

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2025-02-01 DOI:10.1016/j.clinbiomech.2024.106394

Nathalie Maurel , Amadou Diop , Pauline Lallemant-Dudek , Franck Fitoussi

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引用次数: 0

摘要

背景：新生儿臂丛神经麻痹仍然是一种常见的疾病，大多数患者通常表现为主动和被动关节限制，这取决于麻痹的程度。本研究的目的是在Mallet评分任务中比较这些患者的上肢运动学与非受累臂的参考数据库，但也根据瘫痪的程度来表征运动学变化。方法：采用电磁装置进行运动学分析。分析了实现点的位置和运动范围。研究了33例患者的受累臂。根据麻痹程度将患者分为C5-C8±T1组（15例）、C5-C6组（5例）和C5-C7组（13例）。30例患者的非累及组数据作为对照。结果：在对照组和瘫痪组之间以及后者之间发现了许多显著差异。C5-C8±T1组与近端组比较，除口腔任务外，完成点肩胛骨较前伸，肱骨盂上凸较低。除了外旋任务外，肘关节的屈曲活动范围在所有任务中都是不同的，口、颈和脊柱任务的屈曲减少，而抬高任务的屈曲增加。对于口腔任务，C5-C8±T1组的旋后活动范围小于近端组。解释：本研究有助于更好地理解瘫痪对肱骨胸椎、肩胛骨、肩关节和肘关节运动学的影响。

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Upper limb kinematics in patients with neonatal brachial plexus palsy with different levels of palsy

Background

Neonatal brachial plexus palsy remains a frequent condition and most of those patients often present active and passive joint limitation depending of the extend of the palsy. The aim of this study was to compare during the Mallet score tasks the upper limb kinematics of those patients with a reference database of non-involved arms but also to characterize kinematics changes according to the extent of the palsy.

Methods

Kinematic analysis was performed using an electromagnetic device. The point of achievement position and the range of motion were analyzed. The involved arm of thirty-three patients was studied. Several groups of patients were defined depending on the level of the palsy: a C5-C8 ± T1 group (fifteen patients), a C5-C6 group (five patients) and a C5-C7 group (thirteen patients). Data from non-involved arm of thirty patients were used as control.

Findings

Many significant differences were found between the control and palsy groups and between the latter. When comparing the C5-C8 ± T1 and proximal groups, for all except the mouth task, at point of achievement the scapula was more in protraction and glenohumeral elevation was lower. Elbow flexion range of motion was different for all except the external rotation task, with a decreased flexion for mouth, neck and spine tasks and a higher flexion for elevation task. For mouth task, the C5-C8 ± T1 group had a lower supination range of motion than the proximal group.

Interpretation

This study helps to better understand the effect of the palsy on the humerothoracic, scapulothoracic, glenohumeral and elbow kinematics.

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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.