目的 分析改良强制诱导运动疗法(mCIMT)和手-臂双侧强化训练(HABIT)对痉挛型偏瘫儿童上肢功能的疗效,以了解两种疗法特点。方法 选取2018年2—10月在佳木斯大学附属第三医院收治的痉挛型偏瘫儿童30例,并随机分为mCIMT组、HABIT组和对照组各10例,分别接受mCIMT、HABIT和常规OT治疗8周。治疗前后,采用Carroll双上肢功能评定量表(UEFT)、儿童功能独立评定(WeeFIM)、Peabody运动发育量表-精细运动量表(PDMS-FM)、运动效能测试-患手使用程度(MAL-AOU)进行评价。结果 干预后,3组儿童UEFT、WeeFIM、PDMS-FM、MAL-AOL评分与治疗前比较均有显著性提高(P＜0.05或<0.01),其中组间比较,mCIMT和HABIT组儿童4项评定得分均高于对照组(F=6.75,7.01,23.91,21.17,P＜0.01);与mCIMT组对比,HABIT组儿童WeeFIM和MAL-AOU得分明显高于mCIMT组(P＜0.01)。结论 mCIMT和HABIT可改善痉挛型偏瘫儿童的患侧上肢精细功能及使用量、双上肢协调能力,提高功能独立性,其中HABIT在患侧使用量和功能独立性方面疗效优于mCIMT。
Abstract
Objective To analyze the effect of modified constraint-induced movement therapy(mCIMT) versus hand-arm bimanual intensive therapy(HABIT) on the upper extremity function in children with hemiplegic cerebral palsy,in order to figure out the characteristics of mCIMT and HABIT. Methods A total of 30 children with hemiplegic cerebral palsy in the Third Affiliated Hospital of Jiamusi University were enrolled in this study from February to October in 2018,and were randomly divided into mCIMT group,HABIT group and control group,receiving mCIMT,HABIT,and conventional occupational therapy(OT) for 8 weeks,respectively.The Carroll Upper Extremities Functional Test(UEFT),Functional Independence Measure Children's Edition(WeeFIM),Peabody Developmental Motor Scales-Fine Motor(PDMS-FM) and Motor Activity Log-Amount of Use(MAL-AOU) were used to assess the children's function before and after intervention. Results The scores of UEFT,WeeFIM,PDMS-FM and MAL-AOU in the mCIMT group,HABIT group and control group after intervention significantly increased(P＜0.05 or <0.01).And the scores of UEFT,WeeFIM,PDMS-FM and MAL-AOU in mCIMT group and HABIT group were significantly higher than those in the control group(F=6.75,7.01,23.91,21.17,P＜0.01).Compared with mCIMT group,the scores of WeeFIM and MAL-AOU in HABIT group were significantly higher(P＜0.01). Conclusions Both mCIMT and HABIT can improve the fine function and usage,bimanual coordination and functional independence of children with hemiplegic cerebral palsy.Moreover,HABIT is superior to mCIMT in terms of ipsilateral use and functional independence.
关键词
脑性瘫痪 /
改良强制诱导运动疗法 /
手-臂双侧强化训练 /
上肢功能 /
功能独立性
Key words
cerebral palsy /
modified constraint-induced movement therapy /
hand-arm bimanual intensive therapy /
upper extremity function /
functional independence
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