石膏載重鞋對腦性麻痺兒童膝後頂的治療效果：二病例報告

Effect of Weight Bearing Casts on Genu Recurvatum of Cerebral Palsied Children-Report of 2 Cases

吳雪玉(Sheue-Yuh Wu)

《中華民國物理治療學會雜誌》 17卷1期 (1992/03) Pp. 41-46

https://doi.org/10.29616/JPTAROC.199203.0006

摘要

本篇報告了兩位腦性麻痺兒童在接受石膏鞋的治療後膝後頂的改變狀況。病例一，5歲男孩，痙孿型四肢麻痺，在一歲十個月時開始走路，雖穿著支架鞋仍無法消除其站立與走路時的膝後頂。病例二，6歲男孩，痙孿徐動泥合型，四歲半才能放手走路，穿著支架鞋亦無法改善其膝後頂。利用石膏載重鞋將踝關節因定在背屈7度～10度，固定六週後折除，再穿支架鞋以延長石膏效果，並在石膏後，觀察兩病例在站立、穿支架鞋走路與不穿支架鞋走路時膝後頂的現象。病例一共打兩次石膏，第一次石膏後站立與穿支架鞋走路時不再有膝後頂，第二次石膏後不穿支架鞋走路亦無膝後頂。病例二在第一次石膏後，站立及穿著支架鞋走路都不再有膝後頂現象。進一步再分析二例步態形式時發現膝後頂現象雖有改善，但兩病例不穿支架鞋走路時步態與肌肉活動型態仍未正常。

關鍵字

膝後頂 ； 腦性麻痺 ； 痙攣 ； 步態

並列摘要

Use of weight bearing cast in adjunct with therapeutic exercise to fix the ankle joint in dorsiflexion position with 7^0 to 10^0 for 6 weeks, and further brace support can reduce the problem of genu recurvatum in children with cerebral palsy. This paper presents the results in two cases of cerebral palsied children who received the weight bearing cast therapy. The first case was a 6-year-old boy with spastic quadriplegia. He could walk at the age of 1 year and 10 months. Before therapy, when he stood and walked, even with the brace, he had the problem of genu recurvaturn. He received cast therapy twice. After the first cast, the phenomenon of genu recurvaturn subsided when he stood and walked with brace. But it persisted when he walked without brace. After the second cast, this phenomenon subsided even when he walked without brace. The other case was a 6-year-old boy, a victim of spastic athetosis type of cerebral palsy. Before therapy, he was also suffered from genu recurvatum when he stood and walked with brace, while the condition was improved remarkably. Further observations revealed that though the problem of genu recurvatum can be corrected by serial cast, the gait gattern and muscular activity pattern of patients cannot be reverted to normal pattern without the brace.

並列關鍵字

Genu recurvatum ； Cerebral palsy ； Spasticity ； Gait pattern