针刺核心肌群对痉挛型脑瘫患儿躯干控制的影响
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摘要
目的:探讨针刺核心肌群对痉挛型脑瘫患儿躯干控制的影响。方法:选取坐位平衡障碍的痉挛型脑瘫患儿30例,按照简单随机法分为康复组和针刺组各15例,康复组采用针对坐位平衡障碍的康复治疗,针刺组在康复治疗的基础上进行针刺核心肌群,治疗6个月后采用Pro-kin 254平衡训练检测仪检测躯干控制能力及粗大运动功能测试量表88项(GMFM-88)测评中坐位(B区)的评分。结果:(1)针刺组治疗后躯干控制各指标均优于治疗前(P<0.05),康复组治疗后重心摆动轨迹长度优于治疗前(P<0.05),针刺组躯干平均压力中心(COP)前后方向标准差、COP左右方向标准差、前后方向平均运动速度、左右方向平均运动速度、重心移动椭圆面积的治疗前后差值优于康复组(P<0.05)。(2)2组治疗后GMFM-88项坐位评分均高于治疗前(P<0.05),针刺组GMFM-88项坐位评分的治疗前后差值高于康复组(P<0.05)。结论:针刺核心肌群能够改善痉挛型脑瘫患儿坐位躯干控制能力,同时将运动医学理论引入到针刺治疗中,为改善痉挛型脑瘫患儿运动障碍开拓了一个针刺部位选择的新思路。
Objective:To investigate the effects of core muscle acupuncture on the trunk stability control in children with spastic cerebral palsy.Methods:Thirty cases of spastic cerebral palsy children with sitting disequilibrium were selected and divided into equal two groups by simple randomization.The patients of rehabilitation group were taken regular rehabilitation protocol for sitting disequilibrium,while the patients of acupuncture group were taken core muscle acupuncture combined with the same regular rehabilitation protocol mentioned above.The Pro-kin 254 equilibrium training detector was applied to detect the scores of the trunk control ability after six months therapeutic course,along with those in sitting position(region B) among the 88 items in the gross motor function measure(GMFM-88).Results:1) All indicators of trunk stability control in the acupuncture group were superior after treatment compared to those before treatment(P<0.05);the swinging path length of the center of gravity in the rehabilitation group were better after treatment than that before treatment(P<0.05);and the differences in the deviations of the center of pressure(COP) in the anterior-posterior and left-right directions,the average speeds of movement in the anterior-posterior and left-right directions,along with the ellipse area formed by the shifting of the center of gravity before and after treatment in the acupuncture group were superior to those in the rehabilitation group(P<0.05).2) The GMFM-88 scores in sitting position in both groups were better after treatment than those before(P<0.05);and the differences in the GMFM-88 scores in sitting position before and after treatment were better in the acupuncture group than that in the rehabilitation group(P<0.05).Conclusion:Core muscle acupuncture could improve the trunk control in sitting position in children with spastic cerebral palsy;in addition,the introduction of the sport medicine theories into the acupuncture treatment would exploit a new thought for acupuncture site selection in improving the dyskinesia in children with spastic cerebral palsy.
Objective:To investigate the effects of core muscle acupuncture on the trunk stability control in children with spastic cerebral palsy.Methods:Thirty cases of spastic cerebral palsy children with sitting disequilibrium were selected and divided into equal two groups by simple randomization.The patients of rehabilitation group were taken regular rehabilitation protocol for sitting disequilibrium,while the patients of acupuncture group were taken core muscle acupuncture combined with the same regular rehabilitation protocol mentioned above.The Pro-kin 254 equilibrium training detector was applied to detect the scores of the trunk control ability after six months therapeutic course,along with those in sitting position(region B) among the 88 items in the gross motor function measure(GMFM-88).Results:1) All indicators of trunk stability control in the acupuncture group were superior after treatment compared to those before treatment(P<0.05);the swinging path length of the center of gravity in the rehabilitation group were better after treatment than that before treatment(P<0.05);and the differences in the deviations of the center of pressure(COP) in the anterior-posterior and left-right directions,the average speeds of movement in the anterior-posterior and left-right directions,along with the ellipse area formed by the shifting of the center of gravity before and after treatment in the acupuncture group were superior to those in the rehabilitation group(P<0.05).2) The GMFM-88 scores in sitting position in both groups were better after treatment than those before(P<0.05);and the differences in the GMFM-88 scores in sitting position before and after treatment were better in the acupuncture group than that in the rehabilitation group(P<0.05).Conclusion:Core muscle acupuncture could improve the trunk control in sitting position in children with spastic cerebral palsy;in addition,the introduction of the sport medicine theories into the acupuncture treatment would exploit a new thought for acupuncture site selection in improving the dyskinesia in children with spastic cerebral palsy.
引文
[1]中国康复医学会儿童专业委员会.中国脑性瘫痪康复指南[J].中国康复医学杂志,2015,30(7):747-754.
[2]刘跃琴,张惠佳,覃蓉,等.核心控制训练对痉挛型脑性瘫痪的疗效[J].中国康复理论与实践,2014,20(11):1071-1073.
[3]解清云,侯梅,赵建慧,等.核心稳定性训练对痉挛型脑性瘫痪患儿运动功能的影响[J].中国康复医学杂志,2014,29(6):528-532.
[4]李丹,刘军军,刘亚琼,等.核心稳定性训练对脑性瘫痪患儿功能恢复的效果[J].中国康复理论与实践,2015,21(5):583-585.
[5]杨晓颜,杜青,周璇,等.助力电刺激训练对脑性瘫痪患儿核心稳定性的影响[J].中国康复医学杂志,2016,31(1):25-29.
[6]陈维华,宋雄,邹林霞,等.生物反馈结合核心稳定性训练治疗脑瘫疗效观察[J].现代中西医结合杂志,2013,22(17):1877-1888.
[7]LEDERMAN E.The myth of core stability[J].J Bodyw Mov Ther,2010,14(1):84-98.
[8]林栋,庄婉玉,黄晓真,等.目标成就评价量表与针灸临床疗效评价[J].康复学报,2015,25(3):18-22,34.
[9]HAN T,GRAY N,VASQUEZ M M,et al.Comparison of the GMFM-66 and the PEDI Functional Skills Mobility domain in a group of Chinese children with cerebral palsy[J].Child Care Health Dev,2011,37(3):398-403.
[10]VARGUS-ADAMS J N,MARTIN L K,MAIGNAN S H,et al.The GMFM,PEDI,and CP-QOL and perspectives on functioning from children with CP,parents,and medical professionals[J].J Pediatr Rehabil Med,2011,4(1):3-12.
[11]史惟,廖元贵,杨红,等.粗大运动功能测试量表与Peabody粗大运动发育量表在脑性瘫痪康复疗效评估中的应用[J].中国康复理论与实践,2004,10(7):423-424.
[12]刘鹏,黄东锋,江沁,等.脑瘫患儿粗大运动功能测量量表的标准化研究[J].中国康复医学杂志,2004,19(4):170-173.
[13]王绮,肖农,任永平,等.婴幼儿脑性瘫痪粗大运动功能评价量表信度与效度研究[J].重庆医学,2011,40(26):2643-2644.
[2]刘跃琴,张惠佳,覃蓉,等.核心控制训练对痉挛型脑性瘫痪的疗效[J].中国康复理论与实践,2014,20(11):1071-1073.
[3]解清云,侯梅,赵建慧,等.核心稳定性训练对痉挛型脑性瘫痪患儿运动功能的影响[J].中国康复医学杂志,2014,29(6):528-532.
[4]李丹,刘军军,刘亚琼,等.核心稳定性训练对脑性瘫痪患儿功能恢复的效果[J].中国康复理论与实践,2015,21(5):583-585.
[5]杨晓颜,杜青,周璇,等.助力电刺激训练对脑性瘫痪患儿核心稳定性的影响[J].中国康复医学杂志,2016,31(1):25-29.
[6]陈维华,宋雄,邹林霞,等.生物反馈结合核心稳定性训练治疗脑瘫疗效观察[J].现代中西医结合杂志,2013,22(17):1877-1888.
[7]LEDERMAN E.The myth of core stability[J].J Bodyw Mov Ther,2010,14(1):84-98.
[8]林栋,庄婉玉,黄晓真,等.目标成就评价量表与针灸临床疗效评价[J].康复学报,2015,25(3):18-22,34.
[9]HAN T,GRAY N,VASQUEZ M M,et al.Comparison of the GMFM-66 and the PEDI Functional Skills Mobility domain in a group of Chinese children with cerebral palsy[J].Child Care Health Dev,2011,37(3):398-403.
[10]VARGUS-ADAMS J N,MARTIN L K,MAIGNAN S H,et al.The GMFM,PEDI,and CP-QOL and perspectives on functioning from children with CP,parents,and medical professionals[J].J Pediatr Rehabil Med,2011,4(1):3-12.
[11]史惟,廖元贵,杨红,等.粗大运动功能测试量表与Peabody粗大运动发育量表在脑性瘫痪康复疗效评估中的应用[J].中国康复理论与实践,2004,10(7):423-424.
[12]刘鹏,黄东锋,江沁,等.脑瘫患儿粗大运动功能测量量表的标准化研究[J].中国康复医学杂志,2004,19(4):170-173.
[13]王绮,肖农,任永平,等.婴幼儿脑性瘫痪粗大运动功能评价量表信度与效度研究[J].重庆医学,2011,40(26):2643-2644.