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The effects of physical therapy on individual muscle force production and function in children with Cerebral Palsy.

机译：物理疗法对脑瘫患儿个体肌肉力量产生和功能的影响。

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摘要

Cerebral Palsy (CP) is a chronic neurological disorder that affects the ability to perform basic motor tasks, posture, and muscle coordination. Current intervention techniques, including physical therapy, can produce vast improvements in some children, while other children do not respond. The underlying muscular improvements that are associated with physical therapy are unclear, and may be important to understanding why only some children benefit from therapeutic interventions. Musculoskeletal modeling and simulation can be used to determine changes in dynamic muscle force production and muscle contributions to body center of mass accelerations at the individual muscle level as a result of physical therapy. Changes in muscle force and function were characterized for children with CP who participated in both gait and strength training. Gait training significantly affected contributions to body support from the vasti and rectus femoris muscles, and contributions to body propulsion from the soleus, resulting in muscle functional roles more similar to able-bodied gait. Strength training significantly affected gastrocnemius contributions to support, again resulting in muscle function more consistent with able-bodied gait. Changes in muscle function as a result of gait training metrics were significantly correlated to the 6-minute walk test, which is a clinical assessment of muscle endurance. Changes in muscle force and function as a result of strength training were not consistent with measured isometric strength at the joint level, suggesting that dynamic muscle behavior during movement tasks cannot strictly be predicted by static measures. Musculoskeletal modeling and simulation are therefore needed to assess how muscles coordinate to improve mobility. Both types of therapy produced highly variable changes in muscle dynamic metrics across children, which corresponded to the highly variable neuromusculoskeletal impairments of children with CP. The use of musculoskeletal modeling and simulation can identify the muscular deficits of individual children, and have the potential to be instrumental in developing targeted physical therapy protocols that are tailored to a specific patient.
机译：脑瘫（CP）是一种慢性神经系统疾病，会影响执行基本运动任务，姿势和肌肉协调能力。当前的干预技术，包括物理疗法，可以使某些儿童取得巨大进步，而另一些儿童则没有反应。与物理疗法有关的潜在肌肉改善尚不清楚，对于理解为什么只有部分儿童受益于治疗干预可能很重要。肌肉骨骼建模和模拟可用于确定物理疗法的结果，即动态肌肉力量产生的变化以及在单个肌肉水平上肌肉对身体质心加速度的贡献。对参加步态和力量训练的CP儿童表征了肌肉力量和功能的变化。步态训练显着影响股大肌和股直肌对身体支持的贡献以及比目鱼对身体推进的贡献，从而导致肌肉的功能作用与健全的步态更为相似。力量训练显着影响腓肠肌对支撑的贡献，再次导致肌肉功能与健壮步态更加一致。由于步态训练指标而导致的肌肉功能变化与6分钟步行测试显着相关，后者是对肌肉耐力的临床评估。由于进行力量训练而导致的肌肉力量和功能的变化与在关节一级测得的等距力量不一致，这表明运动任务期间的动态肌肉行为不能通过静态测量严格预测。因此，需要进行肌肉骨骼建模和仿真来评估肌肉如何协调以改善活动能力。两种类型的治疗均在儿童中产生了动态变化很大的肌肉动态指标变化，这对应于CP儿童的高度变化性神经肌肉骨骼损伤。肌肉骨骼建模和模拟的使用可以识别单个儿童的肌肉缺陷，并有可能在开发针对特定患者的针对性物理治疗方案中发挥作用。

著录项

  • 作者

    Hegarty, Amy K.;

  • 作者单位

    Colorado School of Mines.;

  • 授予单位 Colorado School of Mines.;
  • 学科 Biomechanics.;Mechanical engineering.
  • 学位 M.S.
  • 年度 2015
  • 页码 99 p.
  • 总页数 99
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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