目的 研究水中运动疗法(AT)联合常规康复疗法(CRT)对学龄前痉挛型脑瘫患儿运动功能的影响,为改善学龄前痉挛型脑瘫患儿运动功能提供理论依据。方法 以2020年1—8月在山东大学齐鲁儿童医院就诊的25例学龄前痉挛型脑瘫患儿为研究对象,随机分为AT+CRT组(12例)和CRT组(13例),分别给予AT+CRT和CRT干预,每周干预5次,共12周。对比干预前后患儿的下肢关节活动度、小腿肌张力、足底接触面积和粗大运动功能。结果 干预后AT+CRT组和CRT组患儿小腿三头肌肌张力、下肢关节活动度和足底接触面积均优于干预前,差异具有统计学意义(AT+CRT组:t=2.803、7.197、3.550、3.730、3.541;CRT组:t=2.941、6.921、4.335、3.199、4.554,P<0.05)。干预后AT+CRT与CRT两组患儿粗大运动功能评定量表(GMFM-88)D区得分,较干预前显著提高,差异均具有统计学意义(t=4.979、3.750,P<0.05),且AT+CRT组提高的幅度大于CRT组,差异具有统计学意义(t=0.757,P<0.05)。干预后AT+CRT组GMFM-88 E区得分相对干预前显著提高,差异具有统计学意义(t=5.244,P<0.05),CRT组差异无统计学意义(P>0.05),AT+CRT组提高的幅度大于CRT组,差异具有统计学意义(t=2.305,P<0.05)。结论 AT+CRT和CRT均能有效改善痉挛型脑瘫患儿的下肢关节活动度、小腿肌张力和足底接触面积。AT+CRT对粗大运动功能的改善效果优于CRT。
Abstract
Objective To study the influence of aquatic motor therapy (AT) combined with conventional rehabilitation therapy (CRT) on the motor function of preschool children with spastic cerebral palsy, in order to provide theoretical basis for improving the motor function of preschool children with spastic cerebral palsy. Methods A total of 25 preschoolers with spastic cerebral palsy who were admitted to Qilu Children's Hospital of Shandong University from January 2020 to August 2020 were enrolled in this study and were randomly divided into AT+CRT group (n=12) and CRT group(n=13).Children in CRT group were given CRT for 12 weeks, while children in AT+CRT received AT additionally, with the frequency of 5 times/week.The range of lower extremity joint motion, calf muscle tone, plantar contact area and gross motor function were compared before and after intervention. Results After intervention, triceps muscle tension, joint motion of lower extremity and plantar contact area in both AT+CRT group and CRT group were all significantly better than those before intervention (AT+CRT group: t=2.803, 7.197, 3.550, 3.730, 3.541; CRT group:t=2.941, 6.921, 4.335, 3.199, 4.554, P<0.05).After intervention, the scores in the D area of the Gross Motor Function Rating Scale (GMFM-88) in both AT+CRT and CRT groups were significantly higher than those before intervention (t=4.979, 3.750, P<0.05), and the improvement in the AT+CRT group was greater than that in the CRT group (t=0.757, P<0.05).After intervention, the score of GMFM-88E in the AT+CRT group was significantly higher than that before intervention (t=5.244, P<0.05), while there was no significant difference in the CRT group (P>0.05).The improvement amplitude in the AT+CRT group was greater than that in the CRT group, with statistical significance (t=2.305, P<0.05). Conclusion Both AT+CRT and CRT can effectively improve the range of motion, calf muscle tone and plantar contact area of lower extremity in children with spastic cerebral palsy, but AT+CRT can improve the gross motion function better than CRT.
关键词
水中运动疗法 /
常规康复疗法 /
脑瘫 /
肌肉张力 /
运动康复
Key words
aquatic motor therapy /
conventional rehabilitation therapy /
cerebral palsy /
muscle tone /
rehabilitation
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基金
国家重点研发计划(2018YFC2000600)
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