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首页> 外文期刊>Developmental Medicine and Child Neurology >Impairment severity selectively affects the control of proximal and distal components of reaching movements in children with hemiplegic cerebral palsy.
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Impairment severity selectively affects the control of proximal and distal components of reaching movements in children with hemiplegic cerebral palsy.

机译：障碍的严重程度有选择地影响偏瘫性脑瘫患儿运动的近端和远端组件的控制。

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摘要

This study explored proximal-to-distal components during goal-directed reaching movements in children with mild or moderate hemiplegic cerebral palsy (HCP); [seven females, four males; mean age 8 y 6 mo; SD 27 mo], compared with age-matched, typically developing children (seven females, five males; mean age 8 y 3 mo [SD 25 mo]. Severity of HCP was assessed following the approach of Claeys et al. Optoelectronic registrations were made during unimanual reaching-to-grasp and reaching-to-hit movements with both the affectedon-preferred and unaffected/preferred side. Regardless of task, the children with HCP, particularly those with moderate impairment, displayed less optimal spatiotemporal organization of movements performed with the affected arm. Compared with the goal to hit, and increasingly with more severe impairment, children with HCP adapted to the goal to grasp by recruiting augmented shoulder movements when reaching with the affected side. A resulting impact on distal kinematics was found in shorter, straighter, and less segmented movement paths. Thus, depending on severity of hemispheric lesions and task complexity, unilateral brain injuries in HCP may selectively affect neural pathways underlying both proximal and distal arm movement control. Levels of both ipsi- and contralateral activation in relation to side and lesion severity should be considered in future studies on prehension movements in HCP.
机译：这项研究探讨了轻度或中度偏瘫性脑瘫（HCP）儿童在目标定向到达运动过程中的近端到远端分量; [七名女性，四名男性;平均年龄8 y 6个月; SD 27 mo]，与年龄相匹配的通常发育中的儿童（七名女性，五名男性;平均年龄8 y 3 mo [SD 25 mo]）进行比较，根据Claeys等人的方法评估了HCP的严重程度。患侧/非偏侧和不偏侧/偏侧的单手伸手抓握和命中击中动作时，无论执行何种任务，患有HCP的儿童，特别是中度障碍的儿童，其动作时空组织的最佳时空安排都较差与击中目标以及越来越严重的损伤相比，HCP儿童在到达患侧时通过增加肩部运动来适应目标，从而对远端运动学产生了影响。更短，更直且分段的运动路径更少，因此，取决于半球病变的严重程度和任务的复杂性，HCP中的单侧脑损伤可能选择性地影响神经近端和远端手臂运动控制的基本途径。在未来有关HCP牵动运动的研究中，应考虑同侧和对侧严重性相关的同侧和对侧激活水平。

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