脑瘫儿童脚尖步态时踝关节位置的低多尺度熵与挛缩发展有关

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2025-03-11 DOI:10.1016/j.clinbiomech.2025.106490

Tony Biakceunung Rungling , Thomas Sinkjær , Jens Bo Nielsen , Jakob Lorentzen , Maria Willerslev-Olsen , Rasmus Feld Frisk

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引用次数: 0

摘要

背景：脑瘫儿童的足趾行走通常比正常发育儿童的足底行走更不稳定，效率也更低。然而，我们假设脑瘫儿童可能由于挛缩的发展而比年龄匹配的正常发育儿童表现出更稳定的脚趾行走。方法利用踝关节垂直位置的多尺度熵来衡量行走站立阶段踝关节的稳定性。37例痉挛性脑瘫患儿以自己喜欢的速度（脑瘫患儿1.3±0.5 km/h，正常发育患儿1.5±0.4 km/h）在跑步机上行走，获得运动数据。来自21名年龄匹配的典型发育儿童的录音用于比较。正常发育的孩子既可以正常走路（跖足），也可以用脚趾走路。研究发现，正常发育儿童脚趾行走时的多尺度熵显著高于足底行走(P <；0.001)。对于6岁以下的儿童，脑瘫儿童的多尺度熵高于正常发育的儿童。对于6岁以上的儿童，观察到的情况正好相反。脑瘫患儿多尺度熵随踝关节被动活动度减小而降低(P <；0.001)。这些发现表明脑瘫患儿的挛缩在脚趾行走时稳定了踝关节。由于早期挛缩的发展，年龄较小的儿童可能表现出更大的稳定性，而年龄较大的儿童的晚期挛缩可能会降低稳定性。

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Low multiscale entropy of ankle joint position during toe gait in children with cerebral palsy is related to contracture development

Background

Toe walking in children with cerebral palsy is typically less stable and less energy-efficient than plantigrade walking in typically developing children. We hypothesized that children with cerebral palsy may, nevertheless, show more stable toe walking due to the development of contractures compared to age-matched typically developing children.

Methods

Multiscale entropy of the vertical position of the ankle joint was used to measure ankle joint stability during the stance phase of walking. Kinematic data were obtained from 37 children with spastic cerebral palsy and habitual toe walking, who walked on a treadmill at their preferred speed (1.3 ± 0.5 km/h for cerebral palsy children and 1.5 ± 0.4 km/h for typically developing children). Recordings from 21 age-matched typically developing children were used for comparison. Typically developing children walked both normally (plantigrade) and on toes.

Findings

Multiscale entropy was significantly higher during toe walking than plantigrade walking in typically developing children (P < 0.001). For children under 6 years, multiscale entropy was higher in cerebral palsy children than in typically developing children. For children over 6 years, the opposite was observed. In children with cerebral palsy, multiscale entropy decreased with reduced passive range of motion in the ankle joint (P < 0.001).

Interpretation

These findings suggest that contractures in children with cerebral palsy stabilize the ankle during toe walking. Younger children may show greater stability due to early contracture development, while advanced contractures in older children may reduce stability.

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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.