目的 探讨镜像疗法对痉挛型偏瘫患儿上肢功能的影响,为治疗提供更多的临床参考意见。方法 选取黄冈平安康复医院2014年1月-2016年1月期间收治的60例痉挛型偏瘫患儿作为研究对象,按照随机数字表的方法分为观察组(n=30)和对照组(n=30),其中对照组患儿予以常规的治疗和康复训练,观察组在对照组基础上采用镜像疗法。分别对两组患儿治疗前、治疗8周和治疗12周后的上肢功能评定量表(QUEST)、Peabody精细运动发育量表(Peabody-FM)、儿童残疾评定量表(PEDI)评分进行比较。结果 治疗前,两组患儿的QUEST分数、Peabody-FM分数和PEDI评分比较差异无统计学意义(P＞0.05);治疗8周和12周后,两组患儿的QUEST分数、Peabody-FM分数和PEDI评分均有不同程度地提高,与对照组比,观察组的QUEST分数、Peabody-FM分数和PEDI评分均明显增高 (P<0.05),以治疗12周后的效果最为明显(P<0.05)。结论 镜像疗法有助于痉挛型偏瘫儿童上肢功能障碍的手-臂结构、功能和双手协作表现及日常生活活动能力,值得推广。
Abstract
Objective To investigate the effect of mirror therapy on upper limb function of children with spastic hemiplegia,so as to provide evidence on treatment. Methods A total of 60 children with spastic hemiplegia in Huanggang Pingan and Rehabilitation Hospital were divided into observation group (n=30) and control group (n=30) by random number table from January 2014 to January 2016.The control group was given routine treatment and rehabilitation training,and the observation group was given the mirror therapy based on the control group.The Quality of Upper Extremity Skill Test (QUEST),Peabody fine motor development scale (Peabody-FM),Pediatrics Evaluation of Disability Inventory(PEDI) were used to assess children's upper limb function before treatment,8 weeks and 12 weeks after treatment and data were compared between the two groups. Results There were no significant differences on the scores of QUEST,Peabody-FM and PEDI of 2 groups before treatment (P＞0.05).After 8 and 12 weeks of treatment,the scores of QUEST,Peabody-FM and PEDI in two groups significantly increased(P＜0.05).Compared with the control group,the scores of QUEST,Peabody-FM and PEDI had improved significantly in the observation group(P＜0.05).The scores of 12 weeks of treatment improved most obviously. Conclusion Mirror therapy is helpful to improve the hand arm structure,function,hand coordination performance and activities of daily living in spastic hemiplegia children with upper limb dysfunction, so it is recommended to be used widely.
关键词
镜像疗法 /
痉挛型偏瘫 /
脑性瘫痪 /
上肢功能
Key words
mirror therapy /
spastic hemiplegia /
cerebral palsy /
upper extremity function
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Gillies MB,Bowen JR,Patterson JA,et al.Educational outcomes for children with cerebral palsy: a linked data cohort study[J].Dev Med Child Neurol,2018,60(4):397-401.
[2] Feitosa LC,Muzzolon SRB,Rodrigues DCB,et al.The effect of adapted sports in quality of life and biopsychosocial profile of children and adolescents with cerebral palsy[J].Rev Paul Pediatr,2017,35(4):429-435.
[3] Sasaki K,Nagase H,Maruyama A,et al.Clinical prediction rule for neurological sequelae due to acute encephalopathy: a medical community-based validation study in Harima,Japan[J].BMJ Open,2017,7(11):e016675.
[4] Haefeli M,Calcagni M.Hemiplegia and cerebral palsy-multidisciplinary treatment of the spastic upper extremity[J].Praxis,2014,103(19):1133-1139.
[5] 吴卫红,姜志梅.第5届全国儿童康复、第12届全国小儿脑瘫康复学术会议暨国际交流会议纪要[J].实用儿科临床杂志,2012,27(18):1460.
[6] Chen Y,He L,Xu K,et al.Comparison of calf muscle architecture between Asian children with spastic cerebral palsy and typically developing peers[J].PLoS One,2018,13(1):e0190642.
[7] El-Shamy SM.Efficacy of Armeo® robotic therapy versus conventional therapy on upper extremity function in children with hemiplegic cerebral palsy[J].Am J Phys Med Rehabil,2018,97(3):164-169.
[8] Harpster K,Miller V.Commentary on "Comparing Unimanual and Bimanual Training in Upper Extremity Function in Children With Unilateral Cerebral Palsy"[J].Pediatr Phys Ther,2017,9(4):306.
[9] Grunt S,Newman CJ,Saxer S,et al.The mirror illusion increases motor cortex excitability in children with and without hemiparesis[J].Neurorehabil Neural Repair,2017,31(3):280-289.
[10] Feltham MG,Ledebt A,Deconinck FJ,et al.Assessment of neuromuscular activation of the upper limbs in children with spastic hemiparetic cerebral palsy during a dynamical task[J].J Electromyogr Kines,2010,20(3):448.
[11] Klepper SE,Clayton KD,Gilb MC,et al.Comparing unimanual and bimanual training in upper extremity function in children with unilateral cerebral palsy[J].Pediatr Phys Ther,2017,29(4):288-306.
[12] Charles J.Upper extremity muscle activation in children with unilateral cerebral palsy during an auditory cued repetitive task: effects on bimanual coordination[J].J Pediatr Rehabil Med,2017,10(1):19-26.
[13] Carson RG.Neural pathways mediating bilateral interactions between the upper limbs[J].Brain Res Brain Res Rev,2005,49(3):641-662.
PDF(492 KB)
