目的 观察孤独症谱系障碍(ASD)儿童跨越不同高度障碍物时步态的时空参数特征,为制定早期运动干预方案和护理措施提供参考,以期降低ASD儿童跌倒风险。方法 2023年11—12月,招募5~7岁ASD儿童和典型发育儿童各30例,使用Footscan®足底压力测试系统,采集无障碍行走以及跨越5cm、15cm高度障碍时足底各区域初始着地时相、触地时间百分比、离地时相以及整足压力中心位移。采用重复测量方差分析比较实验组与对照组在三次测试中各步态指标差异。结果 无障碍行走时,ASD儿童趾骨区域初始着地时相、趾骨和跖骨区域离地时相与典型发育儿童差异有统计学意义(P<0.05);跨越高度障碍时,典型发育儿童相较于无障碍行走,引导腿跖骨和足跟区域的初始着地时相差异有统计学意义(P<0.05),但ASD儿童引导腿足跟区域的初始着地时相在三次测试中不存在显著差异(P>0.05),仅在15cm高度障碍时跖骨区域的初始着地时相变化具有差异(P<0.05)。结论 ASD儿童行走时,在承重反应期表现为跖屈不足,在支撑相末期表现为背屈不足;跨越障碍时表现出更谨慎的动作模式。与典型发育儿童对障碍物的“有无”更敏感不同,ASD儿童对障碍物的“高度”更为敏感。
Abstract
Objective To observe the spatiotemporal gait parameters of children with autism spectrum disorder (ASD) when crossing obstacles of different heights, in order to provide reference for developing early motor intervention programs and nursing strategies to reduce the risk of falls in ASD children. Methods From November to December 2023,thirty children with ASD (aged 5 - 7 years) and thirty typically developed children were recruited.The Footscan® plantar pressure system was used to collect the initial contact time, duration of contact, final contact time, and whole-foot center of pressure displacement during unobstructed walking and when crossing 5 cm and 15 cm obstacles.Repeated measures ANOVA was used to compare gait parameters between the two groups under the three test conditions. Results During unobstructed walking, significant differences were observed between ASD and TD children in the initial contact phase of the toe region, the final contact phase of the toe and metatarsal regions, and COP-X (P<0.05).When crossing obstacles, typically developed children showed significant differences in the initial contact phase of the metatarsal and heel regions of the leading limb compared to unobstructed walking (P<0.05), whereas ASD children showed no significant differences in the heel region across the three trials (P>0.05), with changes only in the metatarsal region when crossing the 15 cm obstacle (P<0.05). Conclusions Children with ASD exhibit insufficient plantar flexion during the loading response phase and insufficient dorsiflexion at the terminal stance during walking.They adopt a more cautious movement pattern when crossing obstacles.Unlike TD children, who are more sensitive to the presence of obstacles, ASD children are more sensitive to obstacle height.
关键词
孤独症谱系障碍 /
步态 /
跨越高度障碍 /
时空参数 /
儿童
Key words
autism spectrum disorder /
gait /
crossing height obstacles /
spatiotemporal parameters /
children
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基金
教育部人文社会科学研究一般项目(23YJ890020)
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