目的 探讨手-臂双侧强化训练对痉挛型偏瘫脑瘫儿童上肢功能障碍及日常生活运动能力的影响,为脑瘫患儿的康复治疗提供依据。方法 选取60例偏瘫型脑瘫儿童随机分为三组:试验A组(20例)、试验B组(20例)和对照组(20例)。对照组采用常规性OT治疗,试验组采用手-臂双侧徒手强化训练(HABIT)治疗,试验A、B组训练时间分别为每日0.5 h、每日1 h。三组分别于治疗前及治疗后8周、12周采用上肢功能评定量表(QUEST)、Peabody精细运动发育量(Peabody-FM)、儿童残疾评定量表(PEDI)进行评定和对比分析。结果 三组儿童治疗后12周QUEST分数、Peabody-FM分数、PEDI分数均优于治疗前(P<0.05),试验A、B组均优于对照组(P<0.05),试验B组均优于试验A组(P<0.05);试验A、B各组组内对比,治疗后不同时长各项评分均有提高,治疗12周时各项评分与治疗8周时各项评分比较差异无统计学意义(P>0.05)。结论 HABIT治疗痉挛型偏瘫脑瘫儿童上肢功能障碍可有效提高儿童患手-臂的结构与功能、双手协作表现、日常生活活动能力,并且每日1 h的HABIT训练较每日0.5 h训练效果好,8周的治疗时间改善效果最为显著。

Objective To watch the effects of Hand-arm Bimanual Intensive Training (HABIT) on the children's upper limb function and ability of daily activity with hemiplegic cerebral palsy. Methods A total of 60 cases in children with hemiplegia type cerebral palsy were randomly divided into three groups:experimental A group (20 cases) and B group (20 cases) and control group (20 cases).On the basis of routine rehabilitation therapy,the control group accepted conventional OT treatment,the experimental test group treated by HABIT of 0.5 hours and 1 hour per day in experimental group A and B training intensity respectively.Three groups respectively had the upper limb skills Quality Test Scale (QUEST),Peabody Develop Getting Motor Scale-Fine Motor (PDMS-FM),Pediatric Evaluation of Disability Inventory (PEDI) before treatment and the 8^th week and the 12^th week after treatment. Results The scores of QUEST,Peabody-FM and PEDI of all children after the 8^th week,the 12^th week treatment were better than those before treatment (P<0.05),the experimental groups were better than control group (P<0.05),the experimental group B was better than the experimental group A (P<0.05);The scores after treatment of experimental A and B groups all improved,but the score of the 12^th week after treatment and that of the 8^th week had no difference (P>0.05). Conclusion HABIT treatment on children with hemiplegic cerebral palsy upper limb dysfunction can effectively improve the structure and function of hand-arm,hands collaboration performance,ability of daily life activities,higher strength HABIT training have better effect,effect of the 8^th week treatment is most significantly improved.