摘要
目的 探讨矫形鞋垫联合肌电生物反馈对小儿脑性瘫痪膝过伸的临床疗效。方法 选取2018年6月至2020年6月在上海市儿童医院治疗的脑性瘫痪伴膝过伸42例患儿为研究对象,随机分为研究组(n=21)和对照组(n=21)。对照组患儿行常规物理运动疗法;研究组患儿在常规疗法的基础上,使用矫形鞋垫联合下肢肌电生物反馈治疗。比较两组患儿治疗前后粗大运动功能评估(gross motor function measure,GMFM)量表-88(D区和E区)评分、步态参数(步长、步宽)、膝过伸角度及改善率等。采用t检验、χ^(2)检验或连续校正χ^(2)检验进行统计学分析。结果 3个月治疗期间,两组患儿均未出现肌肉损伤、关节疼痛等不良反应。治疗前,两组患儿GMFM(D区和E区)评分比较,差异均无统计学意义(P值均>0.05)。3个月治疗后,研究组患儿GMFM-88中D区评分显著高于对照组[(32±3)与(28±4)分,t=2.881,P=0.009)], GMFM-88中E区评分显著高于对照组[(23±5)与(20±6)分,t=2.134,P=0.046)],差异均有统计学意义。治疗前,两组患儿步态参数(步长、步宽)比较,差异均无统计学意义(P值均>0.05)。3个月治疗后,研究组患儿步长显著高于对照组[(24±3)与(21±3)cm, t=2.378,P=0.032],步宽低于对照组[(8.1±0.8)与(8.8±0.9)cm,t=2.183,P=0.037)]。研究组患儿膝过伸改善率[76.2%(16/21)]明显高于对照组[19.0%(4/21)],且差异有统计学意义(χ^(2)=13.745,P=0.001)。研究组患儿膝过伸角度明显小于对照组[(9±4)°与(12±3)°,t=2.908,P=0.008)],差异均有统计学意义。结论 矫形鞋垫联合肌电生物反馈疗法可有效改善脑性瘫痪患儿膝过伸症状,值得在临床推广使用。
Objective To investigate the clinical effect of orthopedic insoles combined with electromyography biofeedback on knee hyperextension in children with cerebral palsy. Method A total of 42 children with cerebral palsy and knee hyperextension who were treated in the Children’s Hospital of Shanghai from June 2018 to June 2020 were selected as the research objects and randomly divided into study group(n=21) and control group(n=21). The children in the control group received conventional physical exercise therapy, while whom in the study group received orthopedic insole combined with lower limb electromyography biofeedback therapy on the basis of conventional therapy. The gross motor function measure(GMFM)-88(zone D and zone E) scores, gait function(step length and step width), knee hyperextension angle and improvement rate were compared between the two groups before and after treatment. Statistical analysis was performed by t-test, χ^(2) test or continuous-corrected χ^(2) test. Result During the 3-month treatment period, there were no adverse reactions such as muscle damage and joint pain in the two groups. Before treatment, there was no significant difference in GMFM(D zone and E zone) scores between the two groups(all P>0.05). After 3 months of treatment, the scores of zone D in GMFM-88 in the study group were significantly higher than that in the control group [(32±3) vs(28±4) points, t=2.881, P=0.009)];In GMFM-88, the scores of zone E in the study group were significantly higher than that in the control group [(23±5) and(20±6) points, t=2.134, P=0.046), the differences were statistically significant. Before treatment, there was no significant difference in gait parameters(step length, step width) between the two groups(all P>0.05). After 3 months of treatment, the step length of the study group was significantly higher than that in the control group [(24±3) vs(21±3) cm, t=2.378, P=0.032], the step width of the study group was better than that in the control group [(8.1±0.8) vs(8.8±0.9) cm, t=2.183, P=0
作者
丁健
唐亮
戴燕琼
陈丽
Ding Jian;Tang Liang;Dai Yanqiong;Chen Li(Department of Rehabilitation,Children's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Children's Hospital of Shanghai,Shanghai 200062,China)
出处
《发育医学电子杂志》
2022年第5期378-382,共5页
Journal of Developmental Medicine (Electronic Version)
基金
国家卫生健康委员会资助项目(2018-2019)
上海市卫生计生系统重要薄弱学科建设项目(2015ZB0402)
上海交通大学医(理)工交叉基金(ZH2018QNA32)。
关键词
脑性瘫痪
膝过伸
肌电生物反馈
矫形鞋垫
粗大运动功能评估
Cerebral palsy
Knee hyperextension
Electromyography biofeedback
Orthopedic insoles
Gross motor function measure
