A Temporal and Distance Gait Studies of Clients with Different Types of Cerebral Palsy

不同類型腦性麻痹患者的時間和空間步態參數之研究

李淑貞(Shwu-Jen Lee) ； 淩汶(Wen Ling)

《中華民國物理治療學會雜誌》 19卷1期 (1994/03) Pp. 17-28

https://doi.org/10.29616/JPTAROC.199403.0003

摘要

本研究之目的在比較痙攣型半身麻痹、痙攣型雙邊麻痹和徐動型四肢麻痹腦性麻痹患者的部份時間和空間步態參數：包括步行速度、每秒步數、步長、和左右腳的步長差。研究對象爲前述三種腦性麻痹類型組各15名患者，共45名。所有腦性麻痹受試者皆可獨立行走10公尺（使用或不使用副木或助行器）。本研究方法為一種測量簡單、高可信度的腳印法。研究結果顯示：三種類型腦性麻痹患者的步行速度、每秒步數和步長有統計上有意義的差別。然而統計結果指出這些腦性麻痹受試者的左右脚的步長差不具有意義的差別。這些結果表示除了步態的對稱性外，殘障的類別和不同型的不正常肌張力對步態的空間和時間參數有影響，顯示步態控制機轉受不同中樞神經損傷的影響頗大。本研究印證由臨床觀察提出的三種類型腦陸麻痹患者的步態是顯著不同的理論。由於大多數的腦性麻痹受試者（包括痙攣性半身麻痹的受試者）均有左右對稱的步態，因此本研究對傳統認爲半身不遂的腦性麻痹患者有不對稱步態之說提出質疑。不過本研究受限於脚印法無法取得更細分的步態時間參數，因此建議未來對不同類型腦性麻痹在步態對稱性之影響做更深入之研究。

關鍵字

腦性麻痹 ； 步態分析

並列摘要

The purpose of this study was to describe and compare selected temporal-distance gait measures, i.e., the velocity, cadence, stride length to lower-extremity length ratio, and stride length differential, among clients with spastic hemiplegia, spastic diplegia and athetoid quadriplegia. Fifteen subjects in each of the aforementioned three types of cerebral palsy were recruited in this study. All subjects were able to walk independently for at least 10m with or without assistive device prior to participating in this study. A clinically approachable, reliable and objective footprint method was employed. The results of this study revealed significant differences (p＜.05) in three of the four selected TD gait measures, including velocity, cadence and stride length to lower- extremity length ratio, among subjects with three different types of cerebral palsy. But, all subjects showed similar stride length differential. The findings indicated the importance of the influence of the distribution of the disability with the types of abnormal posture tone on the performance during ambulation, except for the effect on the symmetry of gait patterns. Most cerebral palsied subjects in this study had fairly symmetrical stride lengths (＜3 cm). Due to the limitation of the footprint method, further studies using other instruments to clarify the effects of specific types of disability on symmetry' of temporal factors during a gait cycle are recommended. The results of this study corresponds to most qualitative description of gait deviation which pointed out differences among the aforementioned three types of cerebral palsy.

並列關鍵字

Cerebral palsy ； Gait analysis