目的 明确学龄期脑瘫青少年的步行能力状况,为制定相应的康复干预策略提供依据。方法 53名脑瘫学生纳入研究,其中男性36例,女性17例;平均年龄(12.2±2.7)岁,范围7.0～17.9岁;粗大运动功能分级(GMFCS):Ⅰ级15例,Ⅱ级38例。采用10 m跑时间(10 m run test,10 mRT)和1 min步行距离(1-minute walk test,1MWT)评价步行速度,6min步行距离(6-minute walk test,6MWT)评价步行耐力,物理消耗指数(physical cost index,PCI)评价步行能量消耗。所有纳入本研究的脑瘫学生均在至少3个月以后再次接受了上述测试。比较首次测试时GMFCSⅠ级和Ⅱ级脑瘫学生各项测试结果之间的差异,同时分析脑瘫学生前后两次各项测试结果的差异。结果 首次测试时GMFCSⅠ级学生的步行速度明显快于GMFCSⅡ级学生(P<0.01),步行耐力也好于GMFCSⅡ级学生(P<0.001),两者PCI值差异无统计学意义;全部脑瘫学生在平均(4.8±1.3)个月后接受了第二次测试,前后两次测试各项测试结果间差异无统计学意义。结论 学龄期脑瘫青少年中GMFCSⅠ级青少年的步行速度、距离明显好于GMFCSⅡ级青少年,但是步行能量消耗无明显差异,短期间隔后各项步行能力测试指标均无明显改变。
Abstract
Objective To determine the waking ability of teenagers with cerebral palsy at school age. Methods Fifty-three students with cerebral palsy were selected including 36 males and 17 females.The average age were (12.2±2.7) years old with range from 7.0 to 17.9.Gross Motor Function Classification System (GMFCS) gradeⅠ had 15 cases and grade Ⅱ had 38 cases.10 m run test (10 mRT) and 1-minute walk test (1MWT) were applied to evaluate the walking speed.6-minute walk test (6MWT) was applied to assess the walking endurance and physical cost index (PCI) was applied to assess the walking energy consumption.All the students accepted retest after at least three months.The first test outcomes between GMFCSⅠand Ⅱ meanwhile and the difference between the first and the second test results were compared. Results In the first test,the walking speed of the students with GMFCS gradeⅠwas significantly faster than those with GMFCS gradeⅡ(P<0.01) and the walking endurance was also better in GMFCS gradeⅠ(P<0.001).There was no statistical difference for the PCI between them.All the students with cerebral palsy received the second test after (4.8±1.3) months of average and there was no statistical difference of the results between the two tests. Conclusions Among the teenagers with cerebral palsy at school age,the walking speed and distance of students with GMFCS gradeⅠ are significantly better than those with GMFCS grade Ⅱ.However,there is no remarkable difference in walking energy consumption.After short-term interval,all the test parameters of walking ability stay the same.
关键词
关键词: 脑瘫 /
步行能力 /
速度 /
耐力 /
能量消耗
Key words
cerebral palsy /
waking ability /
speed /
endurance /
energy consumption
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参考文献
[1] 史惟,杨红,施炳培,等.国内外脑性瘫痪定义、临床分型及功能分级新进展[J].中国康复理论与实践,2009,15(9):801-803.
[2] 史惟,杨红,施炳培,等.脑性瘫痪儿童链式康复服务模式的建设[J].中国康复理论与实践,2015,21(9):1099-1102.
[3] 史惟,丁俊杰,杨红,等.非线性混合效应模型评估脑瘫患儿粗大运动功能发育进程[J].中国循证儿科杂志,2012,7(4):245-251.
[4] Carlon SL,Taylor NF,Dodd KJ,et al.Differences in habitual physical activity levels of young people with cerebral palsy and their typically developing peers: a systematic review[J].Disability & Rehabilitation,2013,35(8):647-655.
[5] Bjornson KF,Chuan Z,Richard S,et al.Walking activity patterns in youth with cerebral palsy and youth developing typically[J].Disability & Rehabilitation,2013,36(15):1279-1284.
[6] 史惟,王素娟,杨红,等.中文版脑瘫患儿粗大运动功能分级系统的信度和效度研究[J].中国循证儿科杂志,2006,1(2):122-129.
[7] 汤加利,史惟,郭金颖,等.学龄期脑瘫儿童步行速度和耐力测试的信度及测量误差[J].中国康复医学杂志,2013,28(10):942-944.
[8] 周美琴,朱晓芸,史惟,等.特殊学校脑瘫儿童步行能量消耗测定的重测信度及测量误差[J].中国康复理论与实践,2012,18(2):152-154.
[9] Sison-Williamson M,Oeffinger D,Bagley A,et al.Analysis of the relationships that body composition and muscular strength have with oxygen cost of walking in children with cerebral palsy[J].Gait & Posture,2014,40(4):628-632.
[10] Wilson NC,Mackey AH,Stott NS.How does the functional mobility scale relate to capacity-based measures of walking ability in children and youth with cerebral palsy?[J].Physical & Occupational Therapy in Pediatrics,2013,34(2):185-196.
[11] Fragala-Pinkham MA,Smith HJ,Lombard KA,et al.Aquatic aerobic exercise for children with cerebral palsy: a pilot intervention study[J].Physiotherapy Theory & Practice,2014,30(2):69-78.
[12] Kholod H,Jamil A,Katz-Leurer M.The associations between motor ability,walking activity and heart rate and heart rate variability parameters among children with cerebral palsy and typically developed controls[J].Neurorehabilitation,2013,33(1):113-119.
[13] Pouliot-Laforte A,Parent A,Ballaz L.Walking efficiency in children with cerebral palsy: relation to muscular strength and gait parameters[J].Computer Methods in Biomechanics & Biomedical Engineering,2014,17(Suppl1):104-105.
[14] Hanna SE,Bartiett D,Rivard LM,et al,Reference curves for the gross motor function feasure:percentiles for clinical description and tracking over time among children with cerebral palsy[J].Physical Therapy,2008,88(5):596-607.
[15] 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.
[16] Maanum G,Jahnsen R,Frslie KF,et al.Walking ability and predictors of performance on the 6-minute walk test in adults with spastic cerebral palsy[J].Developmental Medicine & Child Neurology,2010,52(6):e126-e132.
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