Background

The impairment of selective voluntary motor control (SVMC) in children with cerebral palsy (CP) has been shown to correlate with their gait characteristics using complex 3D gait analysis systems (3DGA); however, this relationship has not been investigated using simple video-based observational gait analysis (VBOGA). The aim of this study was to determine the relationship between VBOGA and SVMC of the lower extremities in children with CP.

Methods

Forty-two CP children 10.9 ± 5.7 years old with Gross Motor Function Classification System (GMFCS) levels I–III participated in the study. Their gait characteristics were assessed using the Edinburgh Visual Gait Score (EVGS), and selective voluntary motor control was tested using the Selective Control Assessment of the Lower Extremity (SCALE). Spearman’s rho correlation test with Cohen’s classification were used in the statistical analyses.

Results

The GMFCS levels (r = 0.604, p < 0.001), foot clearance (r = −0.584. p < 0.001), and maximum ankle dorsiflexion (r =−0.567, p < 0.001) during the swing phase had strong correlations with total SCALE scores. There was also a moderate correlation between total SCALE scores and total EVGS (r =−0.494, p < 0.001), knee extension in the terminal swing phase (r = −0.353, p < 0.001), peak sagittal trunk position (r = −0.316, p < 0.005), and maximum lateral shift (r = −0.37, p < 0.001).

Conclusion

Impaired lower extremity SVMC was noticeably related to the foot and ankle movements in the swing phase and initial stance during walking as well as the total EVGS scores and sagittal and frontal trunk movements. The SCALE correlations with VBOGA were similar those observed in the complex 3DGA in the literature; therefore, we suggest that SVMC impairment of gait could be evaluated using simple VBOGA. These findings may help to tailor physical therapy programs for CP children to increase their motor control and walking quality.

中文翻译：

---

使用基于视频的简单分析确定脑瘫儿童选择性自主运动控制障碍与步态偏差之间的关系

背景

使用复杂的 3D 步态分析系统 (3DGA) 显示，脑瘫 (CP) 儿童的选择性自主运动控制 (SVMC) 受损与其步态特征相关；然而，尚未使用基于视频的简单观察步态分析 (VBOGA) 研究这种关系。本研究的目的是确定 CP 儿童下肢 VBOGA 和 SVMC 之间的关系。

方法

42 名 10.9 ± 5.7 岁的大运动功能分类系统 (GMFCS) 级别 I-III 的 CP 儿童参与了这项研究。使用爱丁堡视觉步态评分 (EVGS) 评估他们的步态特征，并使用下肢选择性控制评估 (SCALE) 测试选择性自愿运动控制。在统计分析中使用了带有 Cohen 分类的 Spearman 的 rho 相关性检验。

结果

摆动阶段的 GMFCS 水平 (r = 0.604, p < 0.001)、足部间隙 (r = -0.584. p < 0.001) 和最大踝背屈 (r = -0.567, p < 0.001) 与总 SCALE 有很强的相关性分数。SCALE 总分与 EVGS 总分（r =-0.494，p < 0.001）、摆动期末期伸膝（r = -0.353，p < 0.001）、躯干矢状位峰值（r = - 0.316, p < 0.005) 和最大横向位移 (r = -0.37, p < 0.001)。

结论

下肢 SVMC 受损与摆动期的足部和踝关节运动、行走时的初始站姿以及总 EVGS 评分和矢状面和额状躯干运动显着相关。与 VBOGA 的 SCALE 相关性与文献中复杂 3DGA 中观察到的相似；因此，我们建议可以使用简单的 VBOGA 评估 SVMC 步态障碍。这些发现可能有助于为 CP 儿童量身定制物理治疗计划，以提高他们的运动控制和行走质量。