摘要
目的探究基于中文版上肢技巧质量测试(Ch-QUEST)的个体化训练联合镜像疗法(MT)对痉挛型偏瘫脑性瘫痪(SHCP)患儿上肢运动功能、日常生活活动(ADL)能力的影响。方法选取SHCP患儿45例,按随机数字表法随机分为对照组(15例)、观察1组(15例)和观察2组(15例)。3组患儿均接受常规康复治疗,包括运动疗法、物理因子疗法、作业疗法等,在此基础上对照组增加40 min的常规上肢功能训练;观察1组在常规康复治疗的基础上增加25 min的常规上肢功能训练和15 min的MT训练;观察2组则增加10 min的常规上肢功能训练、15 min的MT训练和15 min的Ch-QUEST个体化训练。以上训练均为每天1次,每周5 d,连续治疗12周。于治疗前、治疗12周后(治疗后)采用粗大运动功能评估-88(GMFM-88)、Carroll上肢功能评估(UEFT)、儿童功能独立性评估(WeeFIM)和握力、捏力测试系统分别评估3组患儿的粗大运动能力、手功能、ADL能力以及患手的握力和捏力。观察2组患儿于治疗前和治疗后另进行Ch-QUEST评估。结果治疗后,3组患儿的GMFM-88、UEFT、WeeFIM评分与组内治疗前比较,差异均有统计学意义(P<0.05),且观察2组治疗后的GMFM-88评分[(229.13±10.91)分]、UEFT评分[(86.93±8.10)分]和WeeFIM评分[(102.07±16.42)分]均显著优于观察1组和对照组治疗后,差异均有统计学意义(P<0.05)。治疗后,3组患儿手部的握力峰值和后60%平均握力值,以及拇指与示指的捏力峰值和后60%平均捏力值与组内治疗前比较,差异均有统计学意义(P<0.05),且观察2组治疗后的手部的握力峰值和后60%平均握力值,以及拇指与示指的捏力峰值和后60%平均捏力值均显著优于观察1组和对照组治疗后,差异均有统计学意义(P<0.05)。结论Ch-QUEST指导下的个体化训练联合MT训练可更好地改善SHCP患儿的上肢运动功能和ADL能力。
Objective To explore the effectiveness of combining individualized training based on the Chinese quality of upper extremity skill test(Ch-QUEST)with mirror therapy(MT)in rehabilitating the upper limb motor function of children with unilateral spastic cerebral palsy(SHCP).Methods Forty-five children with unilateral spasticity from cerebral palsy were randomly divided into a control group and two observation groups,each of 15.All received routine rehabilitation including kinesitherapy,physical factor therapy and occupational therapy.Five days a week for 12 weeks the control group underwent 40 minutes of routine upper limb function training.Observation group 1 completed 25 minutes of the routine upper limb function training and 15 minutes of MT,while observation group 2 finished 10 minutes of routine upper limb function training,15 minutes of MT and 15 minutes of individualized instruction based on the Ch-QUEST.Before and after the experiment,all the three groups were assessed using gross motor function measure-88(GMFM-88),the Carroll upper extremity function test(UEFT),the functional independence measures for children(WeeFIM)and the E-LINK system.Results After the treatment the average GMFM-88,UEFT and WeeFIM scores of all three groups had improved,with the greatest average improvements in observation group 2.There were also significant grip strength improvements,with those of group 2 significantly better than among the other two groups on average.Conclusion Combining Ch-QUEST-guided individualized training with mirror therapy can better improve the upper limb motor function and ADL of children with SHCP.
作者
王海南
刘鹏
张明
苏春
董建安
袁泉
陈伟
Wang Hainan;Liu Peng;Zhang Ming;Su Chun;Dong Jian'an;Yuan Quan;Chen Wei(The Affiliated Xuzhou Rehabilitation Hospital of Xuzhou Medical University,Xuzhou 221003,China;The Xuzhou Clinical College of Xuzhou Medical University,Xuzhou Central Hospital,Xuzhou 221009,China;Xuzhou Social WelfareInstitute,Xuzhou 221008,China)
出处
《中华物理医学与康复杂志》
CAS
CSCD
北大核心
2024年第6期506-511,共6页
Chinese Journal of Physical Medicine and Rehabilitation
基金
徐州市国家临床重点专科培育项目(2018ZK002)
徐州市卫生健康委青年医学科技创新项目(XWKYHT20200007)。
