目的 应用中文版上肢技巧质量测试量表(Ch-QUEST)指导痉挛型脑性瘫痪患儿的精细运动训练,探讨其在痉挛型脑瘫患儿康复治疗中的应用价值。方法 2016年6月—2017年6月收集徐州市中心医院收治住院和门诊治疗的40例痉挛型脑瘫患儿,随机分为观察组和对照组各20例,两组均进行常规作业治疗,观察组在此基础上加入基于Ch-QUEST手册所应用的示范游戏作为训练方法,每月调整一次训练方案。治疗前后对两组患儿均应用Peabody精细运动发育量表(PDMS-FM)及精细运动功能评估量表(FMFM)进行评定。结果 治疗前观察组与对照组PDMS-FM原始分及FMFM评分无差异统计学意义(P＞0.05),经过3个月治疗后,两组PDMS-FM原始分及FMFM评分均较治疗前明显提高(P＜0.05),且观察组较对照组提高更为显著(P＜0.05)。结论 Ch-QUEST指导下的训练方案对提高痉挛型脑瘫精细运动技能具有良好的临床应用效果。
Abstract
Objective To apply the Chinese Version of the Quality of Upper Extremity Skills Test (Ch-QUEST) in the rehabilitation fine motor training of children with spastic cerebral palsy, and to evaluate its value in clinical application. Methods A total of 40 children with spastic cerebral palsy were recruited and randomly divided into observation and control group with 20 cases in each group. Both groups received routine occupational therapy,and the observation group was given demonstration game based on the Ch-QUEST manual additionally. The plans would be modified every month. Peabody Developmental Motor Scale-Fine Motor (PDMS-FM) and Fine Motor Function Measure (FMFM) were used to evaluate the function of children in two groups before and 3 months after intervention. Results Before treatment,there were no significant differences on raw scores of PDMS-FM and FMFM between observation and control group(P＞0.05). After 3-months treatment,the raw scores of PDMS-FM and FMFM improved significnatly in both groups(P＜0.05).Moreover,the scores were significantly higher in observation group than in control group(P＜0.05). Conclusion The training program based on the guidance of Ch-QUEST is effective clinically on improving fine motor skills in children with spastic cerebral palsy.
关键词
脑性瘫痪 /
痉挛型 /
精细运动 /
中文版上肢技巧质量测试
Key words
cerebral palsy /
spastic /
fine motor /
the Quality of Upper Extremity Skills Test
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] 中国康复医学会儿童康复专业委员会,中国残疾人康复协会小儿脑性瘫痪康复专业委员会,《中国脑性瘫痪康复指南》编委会.中国脑性瘫痪康复指南(2015):第一部分[J].中国康复医学杂志,2015,30(7):747-749.
[2] 史惟.脑瘫儿童上肢功能障碍的评价与治疗[J].中国康复理论与实践,2007,13(12):1121-1123.
[3] DeMatteo C, Law M, Russell D, et al. Quality of upper extremity skill Test[M].Ontario Neurodevelopmental Clinical Research Unit,1992:1.
[4] 刘鹏,姜志梅,汤敬华,等.中文版上肢技巧质量测试量表信度和效度的初步研究[J].中国康复,2013,28(6):424-426.
[5] 史惟,李惠,王素娟,等.用Rasch分析法初步制定脑瘫患儿精细运动功能评估量表[J].中华物理医学与康复杂志,2005,27(5):289-293..
[6] 汤敬华,朱琳,徐磊,等.小组式作业治疗对脑瘫患儿精细运动功能影响的临床研究[J].中国康复,2016,31(1):7-9.
[7] 史惟, 李惠, 苏怡,等.中文版脑瘫患儿手功能分级系统的信度和效度研究[J].中国循证儿科杂志,2009, 4(3):263-269.
[8] Thorley M, Lannin N, Cusick A,et al. Reliability of the quality of upper extremity skills test for children with cerebral palsy aged 2 to 12 years [J].Phys Occup Ther Pediatr, 2012,32(1):4-21.
[9] Klingels K, De Cock P, Desloovere K, et al. Comparison of the melbourne assessment of unilateral upper limb function and the quality of upper extremity skills test in hemiplegic CP [J].Dev Med Child Neurol,2008, 50(12):904-909.
基金
徐州中心医院硕士创新团队科技项目(XZS2013050);徐州市医学青年后备人才工程资助项目(2016015);江苏省青年医学人才(QNRC2016376)。
PDF(628 KB)
