目的 评价不同时期介入主动头部控制训练在斜颈患儿中的干预效果,为促进斜颈患儿的转归及粗大运动发育提供科学依据。方法 选取2022年1月—2023年12月于中国医科大学附属盛京医院第二康复门诊就诊的70例斜颈患儿为研究对象,根据头控训练介入时间不同,分为观察组与对照组各35例,两组均对短缩的胸锁乳突肌进行被动牵伸训练。对照组患儿可以俯卧位主动抬头45°,并且抬头时间≥30s时介入主动的头控训练;观察组在首次治疗开始时就介入主动的头控训练。比较训练前、后两组患儿颈部被动活动度(头向患侧旋转和向健侧侧屈)、双侧胸锁乳突肌厚度比值和粗大运动功能水平。结果 训练后观察组在婴儿运动表现测试总分(96.26±10.01 vs. 89.97±8.96, t=2.769)、诱发条目得分(86.80±9.29 vs. 80.91±7.95, t=2.847)显著高于对照组,差异有统计学意义(P＜0.05);进一步比较训练前后差值,观察组婴儿运动测试总分差值(49.20±10.83 vs. 43.54±7.87, t=2.500)、诱发条目得分差值(43.66±10.30 vs. 38.37±7.33, t=2.474)显著大于对照组,差异有统计学意义(P＜0.05)。结论 早期介入主动头部控制训练,可以促进斜颈患儿粗大运动发育水平和双侧胸锁乳突肌的对称性收缩。
Abstract
Objective To evaluate the intervention effect of active head control training in different periods in children with torticollis, so as to provide scientific basis for promoting the prognosis and gross motor development of these children. Methods A total of 70 children with torticollis who visited the Second Rehabilitation Clinic of Shengjing Hospital of China Medical University from January 2022 to December 2023 were selected as the study subjects. Based on the timing of the introduction of head control training, the children were divided into an observation group and a control group, with 35 children in each group. Both groups underwent passive stretching exercises for the shortened sternocleidomastoid muscle. The control group received active head control training when the child could actively lift their head to 45° in prone position and maintain the position for ≥30s. The observation group received active head control training from the beginning of the first treatment. Neck passive range of motion (rotation to the affected side and lateral flexion to the unaffected side), the ratio of sternocleidomastoid muscle thickness between the two sides, and gross motor function were compared between the two groups before and after training. Results After training, the observation group significantly outperformed the control group in terms of the Test of Infant Motor Performance (TIMP) score (96.26±10.01 vs. 89.97±8.96, t=2.769, P<0.05) and evoked items score (86.80±9.29 vs. 80.91±7.95, t=2.847, P<0.05). Further analysis showed that the differences in TIMP total score (49.20±10.83 vs. 43.54±7.87, t=2.500, P<0.05) and evoked items score (43.66±10.30 vs. 38.37±7.33, t=2.474, P<0.05) between pre- and post-training were significantly greater in the observation group compared to the control group. Conclusion Early intervention with active head control training can promote gross motor development and symmetrical contraction of bilateral sternocleidomastoid muscles in children with torticollis.
关键词
斜颈 /
胸锁乳突肌 /
粗大运动发育 /
早期干预
Key words
torticollis /
sternocleidomastoid muscle /
gross motor development /
early intervention
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基金
中国医科大学附属盛京医院三新项目(2021第221项)
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