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Standing in children with bilateral spastic cerebral palsy : aspects of muscle strength, vision and motor function

机译:站立在双侧痉挛性脑瘫患儿中:肌肉力量,视力和运动功能方面

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摘要

The movement and posture disorder of cerebral palsy (CP) is presumed to mainly be a consequence of the motor disorder, but accompanying disturbances with sensations and perception have also been suggested to influence motor function. The aim was to investigate factors influencing standing posture in children with bilateral spastic CP (BSCP) with varying standing abilities.Three-dimensional motion analysis with surface electromyography was recorded to describe posture during three standing tasks: in a habitual standing position, while blindfolded, and during an attention-demanding task. Muscle strength in the lower limbs was measured with a hand-held dynamometer. Motor function was measured with the Gross Motor Function Measure. The children also underwent a neuro-ophthalmological examination.Almost half of the participants required hand-held support to stand. Investigation of standing posture verified a crouched body position during standing which was more obvious in the children who required hand-held support. Muscle strength measurements indicated that the children in both groups were equally strong in the lower limb muscles despite their variation in standing abilities. The children who stood with support were as capable to perform motor activities in lying, sitting and kneeling positions as the children who stood unsupported.Vision influenced posture differently depending on the children's standing ability. During the attention demanding task, the children who stood unsupported stood more still and with less lower limb muscle activity. While blindfolded, they adapted their posture to the environmental change by activating muscles around the ankle with no changes in overall body position. In contrast, the children who required hand-held support to stand used another strategy;the already flexed body position became even more flexed, and muscle activity increased in the knee extensors while blindfolded, despite the use of external support.Motor disorders could not explain the support for standing or the crouched body position during standing. The children were equally strong in the lower limb muscles and had reasonably similar abilities to perform motor activities in positions with no requirement of standing on the feet opposing gravity. The crouched body position and the reduced ability to maintain posture while blindfolded indicate proprioception deficits in the children who required support. The increased quadriceps muscle activity could be an indication of compensatory co-contraction caused by perceptual impairments. That motor function difficulty arises in a standing position opposing gravity indicates that standing difficulties may be attributable to sensory and/or perceptual disturbances.
机译:推测脑瘫(CP)的运动和姿势障碍主要是运动障碍的结果,但也有人提出伴随感觉和知觉的障碍会影响运动功能。目的是调查影响站立能力不同的双侧痉挛性CP(BSCP)儿童站立姿势的因素。记录有表面肌电图的三维运动分析以描述三个站立任务中的姿势:惯常站立姿势,蒙住眼睛,以及需要注意的任务。用手持式测功机测量下肢的肌肉力量。运动功能通过总运动功能测量来测量。这些孩子还接受了神经眼科检查,几乎一半的参与者需要手持支持才能站立。对站立姿势的研究证实了站立时蹲伏的身体姿势,这在需要手持支撑的儿童中更为明显。肌肉力量测量表明,两组儿童的下肢肌肉都一样强,尽管他们的站立能力有所不同。在没有支撑的情况下,有支撑的孩子在躺,坐和跪姿方面都具有运动能力。视力对姿势的影响取决于孩子的站立能力。在要求注意的任务中,无人站立的孩子站立得更平稳,下肢肌肉活动更少。当被蒙住眼睛时,他们通过激活脚踝周围的肌肉而不改变整体身体位置来适应环境变化。相比之下,需要手持支撑物站立的孩子则采用了另一种策略;已经弯曲的身体姿势变得更加弯曲,被蒙住眼睛的膝盖伸肌的肌肉活动增加了,尽管使用了外部支撑物。站立时的支撑或站立时蹲下的身体姿势。这些孩子的下肢肌肉同样强壮,并且在不需要站立在与重力相反的脚上的姿势中具有相当类似的运动能力。蹲下的身体姿势和蒙住眼睛时保持姿势的能力下降表明需要抚养的儿童的本体感受缺陷。股四头肌肌肉活动增加可能是由知觉障碍引起的代偿性共收缩的迹象。运动功能困难出现在与重力相反的站立位置上,这表明站立困难可能归因于感觉和/或感知障碍。

著录项

  • 作者

    Lidbeck Cecilia;

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  • 年度 2016
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  • 原文格式 PDF
  • 正文语种 eng
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