目的 分析配戴踝足矫形器(AFO)联合康复治疗对脑性瘫痪(CP)患儿肌张力康复的效果,为CP患儿康复提供临床参考。方法 选取郑州大学附属儿童医院2016年3月-2018年10月收治的CP患儿62例。根据治疗方法不同分为对照组和观察组各31例。对照组给予常规康复训练,观察组在常规康复训练基础上配戴AFO。比较两组患儿治疗后的临床疗效。结果 治疗前两组患儿粗大运动功能评定量表(GMFM)评分、肌张力评分和步态参数比较,差异无统计学意义(P>0.05)。治疗后观察组GMFM评分显著高于对照组(t=4.794,P＜0.001);内收肌评分、腓肠肌评分及腘绳肌评分均显著低于对照组(t=4.916、5.694、8.786,P＜0.001);步幅、步速、步长高于对照组,而步频低于对照组(t=2.235、2.247、5.271、7.454,P＜0.05)。结论 CP患儿配戴AFO可改善患儿粗大运动能力,降低患儿肌张力,提高患儿步行能力。
Abstract
Objective To analyze the effect of ankle-foot orthosis (AFO) combined with rehabilitation therapy on the recovery of muscle tension in children with cerebral palsy (CP). Methods A total of 62 CP children in Children's Hospital Affiliated to Zhengzhou University were selected from March 2016 to October 2018.According to the different treatment methods,the patients were divided into control group and observation group,with 31 cases in each group.The control group received routine rehabilitation training,while the observation group was given AFO add itionally.The clinical effect of two groups was compared after treatment. Results There were no significant differences on gross motor function Measure (GMFM) score,muscle tension score and gait parameters between two groups before treatment (P＞0.05).After treatment,the GMFM score of observation group was significantly higher than that of control group (t=4.794,P＜0.001),while the adductor score,gastrocnemius score and hamstring score in observation group were significantly lower than those in control group (t=4.916,5.694,8.786,P＜0.001).Beside,the stride length,step speed,step length in observation group were higher than those in control group,while the stride frequency steps/min was lower than that in control group (t=2.235,2.247,5.271,7.454,P＜0.05). Conclusion Wearing AFO in CP children can improve the gross exercise ability,decrease the muscular tension and improve the walking ability of the children.
关键词
踝足矫形器 /
脑性瘫痪 /
肌张力 /
粗大运动能力 /
步行能力
Key words
ankle-foot orthosis /
cerebral palsy /
muscular tension /
coarse motor ability /
walking ability
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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委员会,《中国脑性瘫痪康复指南》委员会.中国脑性瘫痪康复指南(2015)[J].中国康复医学杂志,2015,30(7):747-754.
[2] 王雪森,闫松华,郑华,等.痉挛型脑瘫儿童动态足底压力分布特征研究[J].北京生物医学工程,2019,38(1):28-35.
[3] 陈雨,历虹,闫诗笛,等.自制下肢姿势维持辅助器具在脑瘫患儿康复护理中的应用[J].护理学杂志,2018,33(20):14-15,35.
[4] 徐怡,赵晓科,朱敏,等.以家庭为中心的护理干预对痉挛型脑性瘫痪患儿踝足矫形器佩戴的影响[J].中国康复理论与实践,2018,24(1):116-120.
[5] 王卫平,孙锟,常立文,等.儿科学[M].9版.北京:人民卫生出版社,2018:100-103.
[6] 伍丹,张洲.踝足矫形器矫治小儿脑瘫尖足的疗效分析[J].按摩与康复医学,2017,8(16):41-42.
[7] Emmens AR,Asseldonk EH,Kooij H.Effects of a powered ankle-footorthosis on perturbed standing balance[J].J Neuro Eng Rehabil,2018,15(1):50.
[8] 李燕平.功能性电刺激联合全方位运动训练对痉挛型脑瘫患儿步行能力与自理能力的影响[J].护理实践与研究,2019,16(4):151-153.
[9] Van DDW,Reints R,Postema K,et al.Development of an ankle-foot orthosis that provides support for flaccid paretic plantarflexor and dorsiflexor muscles[J].IEEE,2018,26(5):1036.
[10] 孔祥颖,宋福祥,庞伟,等.痉挛型脑瘫患儿Bobath球上仰卧起坐训练的疗效观察[J].中国康复医学杂志,2017,32(7):811-813.
[11] 王颖.动静态尖足的痉挛型脑瘫患儿采用踝足矫形器康复护理的效果[J].中国医疗器械信息,2017,23(14):106-107.
[12] 李伟,吴燕丹.踝足矫形器在脑瘫儿童运动康复中的应用研究进展[J].福建师范大学学报:自然科学版,2017,33(3):102-108.
[13] 黄艳芳,何东梅.踝足矫形器在小儿脑瘫康复中的应用价值分析[J].中国医药科学,2018,8(16):73-75,85.
[14] 李亚娟,贾东奇,金伟,等.踝足矫形器对痉挛型脑瘫患儿胫前后肌群疲劳度影响研究[J].创伤与急危重病医学,2017,5(4):251-253.
[15] 叶长青,刘利永,吴宏军,等.脑性瘫痪儿童常用观察性步态量表的研究进展[J].中国康复医学杂志,2018,33(12):1495-1497.
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