Background

Continuous inter-limb coordination and the ability to offset perturbations to a movement pattern (i.e., stability) are important factors in efficient motor performance. Patients with movement disorders often show deficits in coordination and stability, although little is known about these features in children with cerebral palsy. The purpose of this study was to identify the continuous inter-limb coordination and stability deficits in children with cerebral palsy and determine if improvement occurs with upper extremity intervention.

Methods

Children with cerebral palsy participated in bimanual or unimanual intensive therapy. Continuous inter-limb coordination between the arms and between the more-affected arm and leg was evaluated using relative phase analysis during four gross motor tasks, including in-place marching and standing with asymmetric and symmetric arm swing. A control group of children with cerebral palsy and a group of typically developing children were also evaluated.

Findings

Children with cerebral palsy displayed coordination deficits compared to typically developing children (p<0.01), yet both groups presented similarly poor levels of stability (p=0.39). Compared to standing, adding legs to the task negatively impacted the coordination (p<0.01) and stability (p<0.01) of all children. Both groups improved coordination between the arms post-intervention (p<0.05 for all cases), however neither group improved stability (p>0.05 for all cases).

Interpretation

Relative phase analysis successfully provided a sensitive measurement of coordination and stability in pathologic and non-pathologic populations. Findings indicate that all children have difficulty producing consistent movement patterns and suggest that both bimanual and unimanual interventions can improve continuous coordination in children with cerebral palsy.

中文翻译：

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单侧痉挛性脑瘫患儿的连续肢体间协调不足

背景

连续的肢间协调以及将扰动抵消为运动模式的能力（即稳定性）是有效电机性能的重要因素。运动障碍患者通常表现出协调和稳定性方面的缺陷，尽管对脑瘫患儿的这些特征知之甚少。这项研究的目的是确定脑瘫患儿的持续肢间协调和稳定性不足，并确定上肢干预是否会改善病情。

方法

脑瘫患儿参加了单手或单手强化治疗。在四项主要运动任务期间，包括相对行进以及不对称和对称的手臂摆动站立时，使用相对相位分析来评估手臂之间以及受影响最严重的手臂和腿之间的持续肢间协调。还评估了对照组的脑瘫儿童和一组典型的发育中儿童。

发现

与典型发育中的儿童相比，脑瘫儿童表现出协调缺陷（p <0.01），但是两组的稳定性水平均相似（p = 0.39）。与站立相比，增加腿部对所有儿童的协调性（p <0.01）和稳定性（p <0.01）有负面影响。两组均改善了干预后各臂之间的协调性（所有情况下，p <0.05），但是两组均未改善稳定性（所有情况下，p > 0.05）。

解释

相对相位分析成功地提供了病理和非病理人群的协调性和稳定性的灵敏测量。研究结果表明，所有儿童都难以产生一致的运动方式，并且建议双手和单手干预均可改善脑瘫儿童的持续协调能力。