全方位密集运动训练系统在痉挛型脑性瘫痪儿童中的应用疗效研究
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摘要
目的探讨全方位密集运动训练系统(ITP)治疗儿童痉挛型脑性瘫痪的疗效。方法选择2015年7月到2016年12月于安徽医科大学第一附属医院收治的2~<8岁、II~III级痉挛型脑性瘫痪患儿96例,随机分为试验组和对照组,每组48例。对照组采用神经发育学疗法(NDT),试验组在此基础上联合ITP。采用粗大运动功能测试量表(GMFM)、精细运动功能测试量表(FMFM)、Barthel指数量表(ADL)及Berg平衡量表(BBS)比较两组患儿康复治疗前及治疗3个月评分结果。结果试验组共完成46例,对照组共完成44例。治疗前两组的GMFM、FMFM、ADL、BBS评分差值均无统计学意义(P>0.05)。治疗后,试验组GMFM评分为(82.66±11.13)分、FMFM评分为(118.83±19.0)分、ADL评分为(64.24±18.68)分、BBS评分为(35.09±12.50)分,较对照组显著提高,差异有统计学意义(P<0.05)。结论 NDT联合ITP及单用NDT均可提高痉挛型脑性瘫痪儿童的粗大运动功能、精细运动功能、日常生活自理能力和平衡能力,但NDT联合ITP的疗效优于单用NDT。
Objective To explore the efficacy of intensive therapy program( ITP) in the treatment of children with spastic cerebral palsy. Methods A prospective randomized controlled study was performed in 96 patients aged 2 to 8 years old with spastic cerebral palsy from our hospital during July 2015 to December 2016,and they were randomly divided into experimental group and control group. The control group was treated with neurodevelopment therapy( NDT). On the basis of this,the experimental group was treated with ITP. Gross motor function measure( GMFM),fine motor function measure( FMFM),activities of daily living( ADL) and berg balance scale( BBS) were used to assess therapeutic effects before and 3 month after the treatment. Results The control group completed 44 cases and the experimental group completed 46 cases. There were no significant differences in scores of GMFM,FMFM,ADL and BBS between the two groups before treatment( P > 0. 05). After rehabilitation,the scores of GMFM( 82. 66 ± 11. 13),FMFM( 118. 83 ± 19. 0),ADL( 64. 24 ± 18. 68),BBS( 35. 09 ± 12. 50) in the experiment group were higher than those in the control group GMFM( 78. 04 ± 12. 03),FMFM( 105. 45 ± 21. 79),ADL( 53. 07 ± 23. 58),BBS( 26. 30 ± 13. 07),and the difference was statistically significant( P < 0. 05). Conclusion NDT + ITP and NDT alone can improve the gross motor function,fine motor function,activities of daily living and balance ability of children with spastic cerebral palsy. NDT combined with ITP is superior to NDT alone.
Objective To explore the efficacy of intensive therapy program( ITP) in the treatment of children with spastic cerebral palsy. Methods A prospective randomized controlled study was performed in 96 patients aged 2 to 8 years old with spastic cerebral palsy from our hospital during July 2015 to December 2016,and they were randomly divided into experimental group and control group. The control group was treated with neurodevelopment therapy( NDT). On the basis of this,the experimental group was treated with ITP. Gross motor function measure( GMFM),fine motor function measure( FMFM),activities of daily living( ADL) and berg balance scale( BBS) were used to assess therapeutic effects before and 3 month after the treatment. Results The control group completed 44 cases and the experimental group completed 46 cases. There were no significant differences in scores of GMFM,FMFM,ADL and BBS between the two groups before treatment( P > 0. 05). After rehabilitation,the scores of GMFM( 82. 66 ± 11. 13),FMFM( 118. 83 ± 19. 0),ADL( 64. 24 ± 18. 68),BBS( 35. 09 ± 12. 50) in the experiment group were higher than those in the control group GMFM( 78. 04 ± 12. 03),FMFM( 105. 45 ± 21. 79),ADL( 53. 07 ± 23. 58),BBS( 26. 30 ± 13. 07),and the difference was statistically significant( P < 0. 05). Conclusion NDT + ITP and NDT alone can improve the gross motor function,fine motor function,activities of daily living and balance ability of children with spastic cerebral palsy. NDT combined with ITP is superior to NDT alone.
引文
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[4]何璐,徐开寿,邱晒红,等.Berg平衡量表对痉挛型脑性瘫痪儿童平衡功能评定的信度研究[J].中国康复杂志,2010,25(1):21-23.
[5]卢跃鹏.悬吊训练对高危儿早期干预的临床观察[J].医学论坛,2016,27(2):117-118.
[6]HATERN A E,TAREK E,AHMED A.Effect of suspension training versus treadmill training on gross motor abilities of children with spastic diplegic cerebral palsy:a comparative study[J].Eur J Phys Rehabil Med,2016,52(3):356-363.
[7]DODD K J,FOLEY S.Partial body-weight supported treadmill training can improve walking in children with cerebral palsy:a clinical controlled trial[J].Dev Med Child Neurol,2007,49(2):101-105.
[8]BEGNOCHE D M,PITETTI K H.Effects of traditional treatment and partial body weight treadmill training on the motor skills of children with spastic cerebral palsy:a pilot study[J].Pediatr Phys Ther,2007,19(1):11-19.
[9]卫小梅,郭铁成.悬吊运动疗法:一种主动训练及治疗肌肉骨骼疾患的方法[J].中华物理医学与康复,2006,28(4):281-283.
[10]WILLARDSON J M,FONTANA F E,BRESSEL E.Effect of surface stability on core muscle activity for dynamic resistance exercises[J].Int J Sports Physiol Perform,2009,4(1):97-109.
[2]张玲,伍竟,康怀鑫.家庭康复对脑性瘫痪患儿康复的影响[J].实用医学中西医结合临床,2013,13(2):51-53.
[3]REID S M,CARLIN J B,REDDIHOUGH D S.Using the gross motor function classification system to describe patterns of motor severityin cerebral palsy[J].Dev Med Child Neurol,2011,53(11):1007-1012.
[4]何璐,徐开寿,邱晒红,等.Berg平衡量表对痉挛型脑性瘫痪儿童平衡功能评定的信度研究[J].中国康复杂志,2010,25(1):21-23.
[5]卢跃鹏.悬吊训练对高危儿早期干预的临床观察[J].医学论坛,2016,27(2):117-118.
[6]HATERN A E,TAREK E,AHMED A.Effect of suspension training versus treadmill training on gross motor abilities of children with spastic diplegic cerebral palsy:a comparative study[J].Eur J Phys Rehabil Med,2016,52(3):356-363.
[7]DODD K J,FOLEY S.Partial body-weight supported treadmill training can improve walking in children with cerebral palsy:a clinical controlled trial[J].Dev Med Child Neurol,2007,49(2):101-105.
[8]BEGNOCHE D M,PITETTI K H.Effects of traditional treatment and partial body weight treadmill training on the motor skills of children with spastic cerebral palsy:a pilot study[J].Pediatr Phys Ther,2007,19(1):11-19.
[9]卫小梅,郭铁成.悬吊运动疗法:一种主动训练及治疗肌肉骨骼疾患的方法[J].中华物理医学与康复,2006,28(4):281-283.
[10]WILLARDSON J M,FONTANA F E,BRESSEL E.Effect of surface stability on core muscle activity for dynamic resistance exercises[J].Int J Sports Physiol Perform,2009,4(1):97-109.