目的 研究悬吊运动训练(SET)联合肌内效贴治疗不随意运动型脑瘫(DCP)患儿下肢运动功能的疗效,以期为该类型患儿治疗提供临床依据。方法 选取2018年3月—2019年12月在湘雅博爱康复医院儿童康复治疗部收治的59例DCP患儿为研究对象,基于数字表法随机分为3组(常规组20例,悬吊组20例,研究组19例),常规组行常规康复,悬吊组行常规康复和SET,研究组行常规康复+SET+肌内效贴,3组患儿均治疗4个月。比较三组患儿治疗前、治疗4个月的步行能力[10 m步行速度(10 mMWS)]、粗大运动功能[粗大运动功能评定量表88项(GMFM)]与平衡功能[Berg平衡量表(BBS)]评分变化。结果 治疗4个月后,常规组、悬吊组和研究组患儿在10 mMWS(t=3.249、4.042、7.761)、GMFM目标分(t=5.297、13.128、20.982)和BBS评分(t=4.025、7.289、6.394)上较治疗前均显著增高(P<0.01);治疗后,研究组在10 mMWS、GMFM目标分和BBS评分指标改善幅度最佳,并显著优于常规组和悬吊组(F=7.071、4.787、4.093,P<0.05)。结论 SET联合肌内效贴治疗DCP患儿可提高临床治疗疗效,有效改善患儿的平衡功能,粗大运动功能和步行能力。
Abstract
Objective To investigate efficacy of lower limb motor function of sling exercise therapy (SET) combined with kinesio taping on lower limb motor function of children with dyskinetic cerebral palsy,in order to provide clinical evidence for the treatment of these children. Methods A total of 59 children with dyskinetic cerebral palsy in Children's Rehabilitation Department of Xiangya Boai Rehabilitation Hospital were enrolled in this study from March 2018 to December 2019,and were randomly divided into 3 groups,including control group(n=20),SET group(n=20) and study group(n=19). The control group was given routine rehabilitation,SET group received sling exercise therapy additionally,and the study group was treated with kinesio taping based on SET group. The three groups were treated for 4 months. 10m maximum walking speed (10 mMWS),Berg Balance Scale (BBS) and Gross Motor Function Measure (GMFM) were used to evaluate the walking ability,balance and gross motor function of children before treatment and in 4 months after treatment. Results After 4 months of treatment,the scores of 10 mMWS (t=3.249,4.042,7.761),GMFM (t=5.297,13.128,20.982) and BBS(t=4.025,7.289,6.394) of three groups were all better than those before treatment(P<0.01). Additionally,the improvements of 10 mMWS,GMFM and BBS scores in study group were significantly higher than those in control group and SET group(F=7.071,4.787,4.093,P<0.05). Conclusions Sling exercise therapy combined with kinesio taping can strengthen the clinical treatment efficacy of children with dyskinetic cerebral palsy,effectively improve the children's balance function,gross motor function and walking ability.
关键词
不随意运动型脑瘫 /
悬吊运动训练 /
肌内效贴 /
步行能力 /
平衡功能
Key words
dyskinetic cerebral palsy /
sling exercise therapy /
kinesio taping /
walking ability /
balance
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参考文献
[1] Monbaliu E,Himmelmann K,Lin JP,et al.Clinical presentation and management of dyskinetic cerebral palsy[J].Lancet Neurol,2017,16(9):741-749.
[2] 康贝贝,徐磊,卢明甲,等.儿童悬吊训练系统对脑瘫儿童躯干控制及粗大运动功能影响[J].中国儿童保健杂志,2017,25(9):891-893.
[3] 曹美欢,曹建国,贠国俊,等.肌内效贴在脑瘫儿童康复中的应用进展[J].中国康复医学杂志,2016,31(1):102-105.
[4] Shamsoddini A,Rasti Z,Kalantari M,et al.The impact of Kinesio taping technique on children with cerebral palsy[J].Iran J Neurol,2016,15(4):219-227.
[5] Ortiz Ramírez J,Pérez de la Cruz S.Therapeutic effects of kinesio taping in children with cerebral palsy:a systematic review[J].Arch Argent Pediatr,2017,115(6):e356-e361.
[6] 中国脑性瘫痪康复指南编委会.中国脑性瘫痪康复指南(2015)[J].中国康复医学杂志,2015,30(1):749-754.
[7] Bertucco M,Sanger TD.Current and emerging strategies for treatment of childhood dystonia[J].J Hand Ther,2015,28(2):185-194.
[8] 张峰,冯珍.儿童肌张力障碍的研究进展[J].中国康复医学杂志,2018,33(5):593-597.
[9] Eek MN,Olsson K,Lindh K,et al.Intrathecal baclofen in dyskinetic cerebral palsy:effects on function and activity[J].Dev Med Child Neurol,2018,60(1):94-99.
[10] Bonouvrié LA,Becher JG,Vles J,et al.The effect of intrathecal baclofen in dyskinetic cerebral palsy:The IDYS trial[J].Ann Neurol,2019,86(1):79-90.
[11] Cheney PD.Pathophysiology of the corticospinal system and basal ganglia in cerebral palsy[J].Dev Disabi Rs Rvi,2015,3(2):153-167.
[12] SantosAN,Visicatto LP,Oliveira AB,et al.Effects of Kinesio taping in rectus femoris activity and sit-to-stand movement in children with unilateral cerebralpalsy:placebo-controlled,repeated-measuredesign[J].Disabi Rehabil,2019,41(17):2049-2059.
[13] 艾春玲,杜娇娇,焦艳冬,等.肌内效贴在痉挛型和手足徐动型脑性瘫痪患儿康复治疗中的效果[J].中国妇幼保健,2019,32(15):3529-3533.
[14] Hatem AE,Tarek ME.Effect of body-weight suspension training versus treadmill training on gross motor abilities ofchildren with spastic cerebral palsy[J].Eur J Phys Rehabil Med,2016,52(3):356-363.
[15] 王军,郎永斌,杜江华,等.悬吊运动训练对痉挛型脑瘫患儿运动及平衡功能的影响[J].中国当代儿科杂志,2018,20(6):465-469.
[16] 林红.悬吊运动训练系统对不随意运动型脑瘫的康复效果分析[J].中国儿童保健杂志,2019,27(9):62-65.
[17] 贾光素,冉咏秋,赖园园.矫正衣联合悬吊技术治疗不随意运动型脑瘫患儿的疗效观察[J].护理与康复,2019,18(4):5-8.
[18] 任素伟,林春,孟兆祥,等.肌内效贴结合悬吊训练对痉挛型偏瘫患儿运动功能的效果[J].中国康复理论与实践,2016,22(11):1310-1313.
[19] 范桃林,周文颖,陈冬冬,等.悬吊疗法联合肌内效贴对痉挛型脑瘫儿童行走能力的疗效分析[J].中国儿童保健杂志,2019,27(6):652-656.
[20] Kara OK,Uysal SA,Turker D,et al.The effects of Kinesio Taping on body functions and activity in unilateral spastic cerebral palsy:a single-blind randomized controlled trial[J].Dev Med Child Neurol,2015,57(1):81-88.
[21] 金国圣,丁洁,侯梅,等.悬吊训练对痉挛型脑瘫患儿核心稳定性的影响[J].中国儿童保健杂志,2020,28(3):349-351,354.
[22] Elbasan B,Akaya KU,Akyuz M,et al.Effects of neuromuscular electrical stimulation and Kinesio Taping applications in children with cerebral palsy on postural control and sitting balance[J].J Back Musculoskelet Rehabil,2018,31(1):49-55.
基金
湖南省残疾人康复科研资助项目(2020XK028)