轻度下肢不等长儿童的步态参数对称性特征分析
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上海中医药大学附属岳阳中西医结合医院 步态与运动分析中心

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Characterization of the Symmetry of Gait Parameters in Children with Mild Leg Length Discrepancy
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1.Yueyang Hospital of Integrated Traditional and Western Chinese Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai,200437;2.China

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    摘要:

    目的 分析轻度下肢不等长的儿童步态动力学、运动学及时空参数对称性特征,探讨下肢不等长对儿童生长发育可能存在的影响或风险,为早期评估及干预提供理论依据。方法 使用改良的传统三维模型,在每名受试者体表放置 29 个荧光标记点,采集步态参数并计算对称指数。记站立位同侧髂前上棘至外踝荧光标记点的空间距离为下肢长度,纳入下肢长度差值>0.5cm,≤2.5cm的儿童为轻度下肢不等长组59例,下肢长度差值<0.5cm的儿童为正常对照组42例,再按年龄分为1-6周岁组与7-14周岁组,分别进行统计分析,计算组间步态参数的对称指数差异。结果 1-6周岁轻度下肢不等长儿童与正常儿童相比,承重反应期、足蹬离地面垂直方向地反力以及膝关节最大功率的对称指数存在显著差异;7-14周岁轻度下肢不等长儿童与正常儿童相比,骨盆运动范围的对称指数存在显著差异。结论 低年龄段儿童不等长下肢的肌肉力量、控制能力不平衡,随着步态模式发育成熟,不平衡的表现出现在骨盆运动层面,提示了临床上应予及时关注或早期评估。

    Abstract:

    Objective To analyze the symmetry characteristics of gait dynamics, kinematics and spatial and temporal parameters in children with mild Leg Length Discrepancy (LLD), and to explore the possible influence or risk of LLD on children"s growth, so as to provide theoretical basis for early assessment and intervention. Methods Using a modified traditional three-dimensional model, 29 markers were placed on the body surface of each subject to collect gait parameters and calculate the symmetry index (SI). The spatial distance of the ipsilateral markers between anterior superior iliac spine and the external ankle in the standing position was recorded as the length of the legs, and children with more than 0.5 cm and less than 2.5 cm leg length difference were included in the group of 59 cases with mild LLD, and those with less than 0.5cm leg length difference were included in the group of 42 cases as the control group, and then divided into the groups of 1-6 and 7-14 years of age according to the ages of the children and were statistically analyzed separately, and the symmetry index difference of the gait parameters was calculated between groups. Results The SI of the vertical ground reaction force and the maximum power of the knee joint were significantly different between children with mild LLD and normal children aged 1-6. The SI of the pelvis motion were significantly different between children with mild LLD and normal children aged 7-14. Conclusions The imbalance in muscle strength and control of the unequal leg length in children in the younger age groups, and the imbalance at the pelvic motion appears as the gait pattern matures, suggests clinical attention or early assessment.

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  • 收稿日期:2024-06-04
  • 最后修改日期:2024-06-25
  • 录用日期:2024-06-27
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