运动学分析法在痉挛型脑性瘫痪中的临床研究
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摘要
目的探讨运动学分析法在痉挛型脑性瘫痪(简称脑瘫)中的应用。方法选择2018年2月至11月河南省儿童医院康复医院收治的痉挛型脑瘫患儿60例为研究对象,随机分为对照组和观察组各30例。对照组采用以Bobath疗法为主综合康复治疗方法,观察组于干预前采用运动学分析法找出患儿坐位姿势异常的运动元素,在其指导下制定康复方案。两组于干预前后进行粗大运动功能测试量表(GMFM)B区检测、Berg平衡量表评测。结果治疗前两组患儿GMFM量表B区评分和Berg平衡量表评分比较差异无统计学意义(P>0.05);治疗后两组患儿GMFM量表B区评分和Berg平衡量表评分显著高于治疗前,且观察组评分显著高于对照组,差异均有统计学意义(P<0.05)。结论运动学分析法可用于指导痉挛型脑瘫康复训练且疗效显著。
Objective To explore the application of kinematics analysis method in spastic cerebral palsy.Methods Sixty cases of spastic cerebral palsy were randomly divided into the control group and the observation group. The control group was treated with Bobath therapy as the main comprehensive rehabilitation method. In the observation group the kinematic analysis method was used to find the sport element for abnormal posture of the child before the intervention, and under its guidance,a rehabilitation program was developed. The GMFM gross motor function scale B area test and Berg balance scale were evaluated before and after the intervention.Results There was no significant difference in the total score of the B-zone or the total score of the Berg balance scale before intervention between the two groups(P>0.05). The total score of the B-zone and the total score of the Berg balance scale after intervention were significantly higher than those before intervention in the two groups, and the scores of the observation group were significantly higher than those of the control group(P<0.05).Conclusion The kinematics analysis method can be used to guide the rehabilitation of spastic cerebral palsy and its curative effect is remarkable.
Objective To explore the application of kinematics analysis method in spastic cerebral palsy.Methods Sixty cases of spastic cerebral palsy were randomly divided into the control group and the observation group. The control group was treated with Bobath therapy as the main comprehensive rehabilitation method. In the observation group the kinematic analysis method was used to find the sport element for abnormal posture of the child before the intervention, and under its guidance,a rehabilitation program was developed. The GMFM gross motor function scale B area test and Berg balance scale were evaluated before and after the intervention.Results There was no significant difference in the total score of the B-zone or the total score of the Berg balance scale before intervention between the two groups(P>0.05). The total score of the B-zone and the total score of the Berg balance scale after intervention were significantly higher than those before intervention in the two groups, and the scores of the observation group were significantly higher than those of the control group(P<0.05).Conclusion The kinematics analysis method can be used to guide the rehabilitation of spastic cerebral palsy and its curative effect is remarkable.
引文
[1] Park MJ,Yoo YJ,Chung CY,et al.Ocular findings in patients with spastic type cerebral palsy[J].BMC Ophthalmol,2016,16(1):195.
[2] 唐久来,秦炯,邹丽萍,等.中国脑性瘫痪康复指南(2015):第一部分[J].中国康复医学杂志,2015,30(7):747-754.
[3] 丁婷,吴素英.痉挛型脑瘫治疗新进展[J].世界最新医学信息文摘,2018,18(86):34-35.
[4] Bax M,Goldstein M,Rosenbaum P,et al.Proposed definition and classification of cerebral palsy,April 2005[J].Dev Med Child Neurol,2005,47(8):571-576.
[5] Farajzadeh A,Amini M,Maroufizadeh S,et al.Caregiver Difficulties Scale (CDS):Translation and Psychometric Evaluation Among Iranian Mothers of Cerebral Palsy Children[J].Occup Ther Health Care,2018,32(1):28-43.
[6] 金彩君,张丽华,单丽艳,等.感觉统合训练对痉挛型脑瘫患儿步态影响的临床研究[J].中国中西医结合儿科学,2011,3(3):206-210.
[7] 周崇臣,尚清.婴幼儿运动障碍评估与康复[M].北京:北京大学医学出版社,2017.
[8] Wright FV,Rosenbaum P,Fehlings D,et al.The Quality Function Measure:reliability and discriminant validity of a new measure of quality of gross motor movement in ambulatory children with cerebral palsy[J].Dev Med Child Neurol,2014,56(8):770-778.
[9] 史惟,朱默,翟淳,等.基于ICF-CY的脑瘫粗大运动功能测试量表内容效度分析[J].中国康复理论与实践,2013,19(1):13-18.
[10] Jantakat C,Ramrit S,Emasithi A,et al.Capacity of adolescents with cerebral palsy on paediatric balance scale and Berg balance scale[J].Res Dev Disabil,2015,36C:72-77.
[11] 何璐,徐开寿,邱晒红,等.Berg平衡量表对痉挛型脑瘫儿童平衡功能评定的信度研究[J].中国康复,2010,25(1):21-23.
[12] 有马正高,北原吉原,陈秀洁.小儿的姿势[M].北京:北京大学出版社,2016.
[13] Smart LJ Jr,Mobley BS,Otten EW,et al.Not just standing there:the use of postural coordination to aid visual tasks[J].Hum Mov Sci,2004,22(6):769-780.
[14] Collins KC,Kennedy NC,Clark A,et al.Getting a kinematic handle on reach-to-grasp:a meta-analysis[J].Physiotherapy,2018,104(2):153-166.
[15] Fuchs PX,Lindinger SJ,Schwameder H.Kinematic analysis of proximal-to-distal and simultaneous motion sequencing of straight punches[J].Sports Biomech,2018,17(4):512-530.
[16] Kim J,Yi J,Song CH.Kinematic analysis of head,trunk,and pelvic motion during mirror therapy for stroke patients[J].J Phys Ther Sci,2017,29(10):1793-1799.
[17] Collins KC,Kennedy NC,Clark A,et al.Kinematic Components of the Reach-to-Target Movement After Stroke for Focused Rehabilitation Interventions:Systematic Review and Meta-Analysis[J].Front Neurol,2018,9:472.
[18] Abbasi L,Rojhani-Shirazi Z,Razeghi M,et al.Trunk Kinematic Analysis during Gait in Cerebral Palsy Children with Crouch Gait Pattern[J].J Biomed Phys Eng,2018,8(3):281-288.
[19] 王立苹,孙奇峰,王丹,等.运动控制训练对脑性瘫痪患儿粗大运动功能影响研究[J].中国中西医结合儿科学,2015,7(2):148-150.
[20] 邱卓英,李沁燚,陈迪,等.ICF-CY理论架构、方法、分类体系及其应用[J].中国康复理论与实践,2014,20(1):1-5.
[21] 刘合建,邱卓英,周文萍,等.ICF-CY理论与方法在脑性瘫痪康复中的应用[J].中国康复理论与实践,2014,20(1):6-10.
[22] 世界卫生组织.国际功能、残疾和健康分类(儿童和青少年版)[M].邱卓英译.日内瓦:世界卫生组织,2013.
[23] Gerold STUCKI,John MELVIN,卢雯,等.《国际功能、残疾和健康分类》:对物理和康复医学进行统一概念描述的模式[J].中国康复理论与实践,2008,14(12):1108-1111.
[2] 唐久来,秦炯,邹丽萍,等.中国脑性瘫痪康复指南(2015):第一部分[J].中国康复医学杂志,2015,30(7):747-754.
[3] 丁婷,吴素英.痉挛型脑瘫治疗新进展[J].世界最新医学信息文摘,2018,18(86):34-35.
[4] Bax M,Goldstein M,Rosenbaum P,et al.Proposed definition and classification of cerebral palsy,April 2005[J].Dev Med Child Neurol,2005,47(8):571-576.
[5] Farajzadeh A,Amini M,Maroufizadeh S,et al.Caregiver Difficulties Scale (CDS):Translation and Psychometric Evaluation Among Iranian Mothers of Cerebral Palsy Children[J].Occup Ther Health Care,2018,32(1):28-43.
[6] 金彩君,张丽华,单丽艳,等.感觉统合训练对痉挛型脑瘫患儿步态影响的临床研究[J].中国中西医结合儿科学,2011,3(3):206-210.
[7] 周崇臣,尚清.婴幼儿运动障碍评估与康复[M].北京:北京大学医学出版社,2017.
[8] Wright FV,Rosenbaum P,Fehlings D,et al.The Quality Function Measure:reliability and discriminant validity of a new measure of quality of gross motor movement in ambulatory children with cerebral palsy[J].Dev Med Child Neurol,2014,56(8):770-778.
[9] 史惟,朱默,翟淳,等.基于ICF-CY的脑瘫粗大运动功能测试量表内容效度分析[J].中国康复理论与实践,2013,19(1):13-18.
[10] Jantakat C,Ramrit S,Emasithi A,et al.Capacity of adolescents with cerebral palsy on paediatric balance scale and Berg balance scale[J].Res Dev Disabil,2015,36C:72-77.
[11] 何璐,徐开寿,邱晒红,等.Berg平衡量表对痉挛型脑瘫儿童平衡功能评定的信度研究[J].中国康复,2010,25(1):21-23.
[12] 有马正高,北原吉原,陈秀洁.小儿的姿势[M].北京:北京大学出版社,2016.
[13] Smart LJ Jr,Mobley BS,Otten EW,et al.Not just standing there:the use of postural coordination to aid visual tasks[J].Hum Mov Sci,2004,22(6):769-780.
[14] Collins KC,Kennedy NC,Clark A,et al.Getting a kinematic handle on reach-to-grasp:a meta-analysis[J].Physiotherapy,2018,104(2):153-166.
[15] Fuchs PX,Lindinger SJ,Schwameder H.Kinematic analysis of proximal-to-distal and simultaneous motion sequencing of straight punches[J].Sports Biomech,2018,17(4):512-530.
[16] Kim J,Yi J,Song CH.Kinematic analysis of head,trunk,and pelvic motion during mirror therapy for stroke patients[J].J Phys Ther Sci,2017,29(10):1793-1799.
[17] Collins KC,Kennedy NC,Clark A,et al.Kinematic Components of the Reach-to-Target Movement After Stroke for Focused Rehabilitation Interventions:Systematic Review and Meta-Analysis[J].Front Neurol,2018,9:472.
[18] Abbasi L,Rojhani-Shirazi Z,Razeghi M,et al.Trunk Kinematic Analysis during Gait in Cerebral Palsy Children with Crouch Gait Pattern[J].J Biomed Phys Eng,2018,8(3):281-288.
[19] 王立苹,孙奇峰,王丹,等.运动控制训练对脑性瘫痪患儿粗大运动功能影响研究[J].中国中西医结合儿科学,2015,7(2):148-150.
[20] 邱卓英,李沁燚,陈迪,等.ICF-CY理论架构、方法、分类体系及其应用[J].中国康复理论与实践,2014,20(1):1-5.
[21] 刘合建,邱卓英,周文萍,等.ICF-CY理论与方法在脑性瘫痪康复中的应用[J].中国康复理论与实践,2014,20(1):6-10.
[22] 世界卫生组织.国际功能、残疾和健康分类(儿童和青少年版)[M].邱卓英译.日内瓦:世界卫生组织,2013.
[23] Gerold STUCKI,John MELVIN,卢雯,等.《国际功能、残疾和健康分类》:对物理和康复医学进行统一概念描述的模式[J].中国康复理论与实践,2008,14(12):1108-1111.