关键词: 离心收缩, 强制诱导运动疗法, 痉挛型偏瘫, 上肢运动功能, 表面肌电图

Abstract: Objective To observe the effects of eccentric exercise combined with constraint-induced movement therapy(CIMT) on the upper limb function and activities of daily living in children with spastic hemiplegic cerebral palsy, so as to provide reference for the clinical treatment and rehabilitation. Methods A total of 42 children with spastic hemiplegic cerebral palsy, who were treated in Nantong Maternal and Child Health Care Hospital from January 2020 to June 2021 and met the inclusion criteria, were enrolled in this study and were randomly divided into combined group(n=21) and control group(n=21). Both combined group and control group received traditional rehabilitation and CIMT, while the combined group received eccentric exercise therapy additionally. The upper limb flexor muscle tension, upper limb and hand function and activities of daily living of the two groups were assessed by the modified Ashworth scale(MAS), Carroll upper extremities functional test(UEFT), modified Barthel index(MBI) and root mean square value(RMS) of the surface electromyography of the biceps brachii, and were compared before and after 12-week treatment. Results Before treatment, the MAS score, UEFT score, MBI score and RMS of the surface electromyography of the biceps brachii were not significantly different between combined group and control group(P＞0.05). After 12 weeks of treatment, both UEFT score and MBI score of the two groups were significantly improved than those before treatment(P＜0.05), and the scores of the combined group increased more significantly than the control group(t=2.641, 7.258, P＜0.05). The MAS scores and RMS in the two groups were significantly lower than those before treatment(P＜0.05), and the scores of the combined group were significantly lower than those of the control group(Z=2.706, t=3.623, P＜0.05). Conclusions Eccentric contraction training combined with CIMT can improve the tension of the elbow flexion muscle, the upper limb motor function and activities of daily living in children with spastic hemiplegic cerebral palsy, which is worthy of wide use in clinic.

Key words: eccentric contraction, constraint-induced movement therapy, spastic hemiplega, upper limb motor function, surface electromyography