基于三维步态分析学龄期斜颈儿童运动学时空参数及特征
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1.上海中医药大学附属岳阳中西医结合医院;2.上海中医药大学

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R726.8;R318.01

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Research on Temporal - spatial Parameters and Kinematic Characteristics of School - age Children with Torticollis Based on Three - dimensional Gait Analysis
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1.Yueyang Hospital of Traditional Chinese and Western Medicine;2.Shanghai University of Traditional Chinese Medicine

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    摘要:

    目的 本研究旨在通过三维步态分析系统,评估6-12岁学龄期先天性肌性斜颈(Congenital Muscular Torticollis,CMT)儿童的运动功能,并分析其步行运动的时空参数和躯干及下肢的运动学参数,探讨CMT对儿童的生长发育可能产生的远期影响。方法 采用三维步态分析技术,对CMT儿童的步态进行详细评估并与正常儿童进行比较,分析躯干、骨盆及髋、膝、踝关节运动角度及范围,时空参数。纳入31名6-12岁CMT儿童为斜颈组,31名6-12岁正常儿童为对照组,并将斜颈组数据根据斜颈的患病侧分为健侧和患侧,三组间进行统计分析,计算运动学和时空参数的差异。结果 与同年龄段正常组儿童相比,斜颈组患侧、健侧的步长、步速、支撑相时间百分比、摆动相踝平均内翻角度、支撑相踝平均内翻角度、支撑相足偏角均值、足相对胫骨内旋平均角度、支撑相膝外翻角度均值、肩关节上下均值、着地肩关节高度三组间存在显著差异,其中斜颈组健患侧步长、步速、踝内翻角度、膝外翻角度、足外偏角度均显著低于正常组,支撑相时间百分比、足相对胫骨内旋角度高于正常组。结论 CMT儿童的整体运动发育异常在学龄期仍有残余表现,且对非受累侧同样产生影响,发生高低肩的风险较高,整体步行效率较同年龄段正常儿童减低,存在踝关节稳定性不足等下肢运动异常表现。

    Abstract:

    Objective This study aims to assess the motor function of children with Congenital Muscular Torticollis(CMT), aged 6-12 years using a three-dimensional gait analysis system, and to analyze the spatiotemporal parameters of their walking motion as well as the kinematic parameters of the trunk and lower limbs. The goal is to explore the potential long-term impact of CMT on the growth and development of children. Methods Using three - dimensional gait analysis technology, the gait of children with CMT was evaluated in detail and compared with that of normal children. The motion angles and ranges of the trunk, pelvis, hip, knee, and ankle joints, along with spatio - temporal parameters, were analyzed. Thirty - one children with torticollis aged 6 - 12 years were recruited into the torticollis group, and 31 normal children of the same age range were included in the control group. The data of the torticollis group were divided into the healthy side and the affected side based on the side of the torticollis. Statistical analysis was performed among the three groups to calculate the differences in kinematic and spatio - temporal parameters. Results Compared with the normal group of children of the same age, significant differences were observed in the affected and unaffected sides of the torticollis group in terms of stride length, gait speed, percentage of support phase time, average ankle inversion angle during the swing phase, average ankle inversion angle during the support phase, average foot orientation angle during the support phase, average ankle internal rotation angle relative to the tibia during the stance phase, average knee valgus angle during the stance phase, average shoulder joint elevation, and shoulder joint height at landing. Specifically, the torticollis group had significantly lower stride length, gait speed, ankle inversion angle, knee valgus angle, and foot eversion angle on both the affected and unaffected sides compared to the normal group, while the percentage of support phase time and the internal rotation angle of the foot relative to the tibia during the stance phase were higher than those in the normal group. Conclusion In school - age children with CMT , there are still residual manifestations of overall motor development abnormalities. These abnormalities also affect the non - affected side. They have a relatively high risk of developing uneven shoulders, their overall walking efficiency is lower than that of normal children of the same age, and they exhibit lower - limb motor abnormalities such as insufficient ankle joint stability.

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  • 收稿日期:2025-01-03
  • 最后修改日期:2025-01-21
  • 录用日期:2025-01-22
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