摘要
目的:运用三维运动解析系统评价全身垂直律动疗法改善痉挛型脑瘫患儿运动学参数的效果。方法:对2018年1月至2019年1月同济大学附属养志康复医院收治的18例痉挛型脑瘫患儿(试验组),按照相同年龄、相同GMFCS分级,同期与上海交通大学附属上海儿童医学中心康复医学科收治痉挛型脑瘫患儿(对照组)进行1∶1配对,如果配对过程中有多名患儿符合配对条件,则选用简单随机法确定配对对象,总计36例样本。其中对照组进行常规康复训练,试验组在常规康复训练的基础上再进行全身垂直律动疗法干预。所有患儿每周均接受3次常规康复训练,包括PT、OT、ST、中医传统康复等,以及每天至少60min的居家训练,3个月为1个疗程,总计两个疗程;试验组在此基础上再进行全身垂直律动疗法干预,每周3次,每次25min,3个月为1个疗程,总计两个疗程。试验前后,采用三维运动解析系统对两组患儿步行时空参数(步长、步速、步频、步宽、支撑相%、摆动相%)及下肢各关节支撑相运动学参数进行分析,并对两组儿童进行物理治疗评定及66项粗大运动功能评估(gross motor function measure-66,GMFM-66),评估脑瘫患儿整体功能情况,分析其疗效差异。结果:两组患儿治疗前后物理治疗评定(伸膝—踝背屈角度、腘角角度、Ely试验、Thomas试验)、步行时空参数(步长、步宽)、运动学参数(支撑相时髋关节屈曲角度、支撑相时踝关节跖屈角度)及GMFM-66分数均有显著性差异(P<0.05)。其中试验组治疗后物理治疗评定(伸膝—踝背屈角度、腘角角度、Ely试验、Thomas试验)、步行时空参数(步长、步宽)、运动学参数(支撑相时踝关节跖屈角度、支撑相时髋关节屈曲角度)及GMFM-66分数指标均优于对照组,差异有显著性意义(P<0.05)。结论:相较于常规康复训练,全身垂直律动疗法结合常规康复训练可有效地缓解脑瘫患儿肌肉痉挛
Objective:To explore the impact of whole body vibration therapy(WBV)on the kinematic parameters of children with spastic cerebral palsy based on three-dimensional gait analysis.Method:From January 2018 to January 2019,18 children with spastic cerebral palsy admitted to the Yangzhi Rehabilitation Hospital Affiliated to Shanghai Tongji University were enrolled.18 children matched in age and GMFCS in Shanghai Children's Medicine Center were enrolled also.If more than one child in Shanghai Children's Medicine Center matched,a simple random method was used to determine whom should be chosen.18 children from the Yangzhi Rehabilitation Hospital(experimental group)were treated with WBV and comprehensive rehabilitation,other 18 children from Shanghai Children's Medicine Center(control group)were treated with comprehensive rehabilitation only.Both groups received comprehensive rehabilitation treatment 40 minutes per session,3 sessions a week,and additional training at least 60 minutes per day at home.The experimental group received additional WBV 3 times a week,25 minutes each time.Both groups took 3 months a course and two courses in total.Before and after treatment,physical assessment,three-dimensional gait analysis and Gross motor function measure-66(GMFM-66)was used to evaluate passive joint range of motion,muscle length,walking time and space parameters(step length,pace,stride frequency,step width,support phase%,swing phase%),kinematic parameters and motor function for two groups.Result:After treatment,physical assessment(knee extension-ankle dorsiflexion angle,popliteal angle,Ely test,Thomas test),space parameters(step length,step width),kinematics parameters(support-phase hip flexion angle,support-phase ankle plantar flexion angle)and GMFM-66 score were all significantly improved(P<0.05)for both groups.The experimental group improved more than that of the control group(P<0.05).Conclusion:WBV with comprehensive rehabilitation can effectively improve the abnormal movement pattern of children with spastic cerebral pals
作者
徐纯鑫
金晟
陈岑
陆洋阳
翟歆昳
沈敏
任婕
程慧
XU Chunxin;JIN Sheng;CHEN Cen(Yangzhi Rehabilitation Hospital,Tongji University,Shanghai,201613)
出处
《中国康复医学杂志》
CAS
CSCD
北大核心
2023年第8期1066-1072,共7页
Chinese Journal of Rehabilitation Medicine
基金
上海市养志康复医院院内科研项目(YJKYQN202010)
上海市卫生健康委员会临床科研项目(20214Y0154)。
关键词
痉挛型脑性瘫痪
全身律动
三维运动解析
运动学参数
spastic cerebral palsy
whole body vibration therapy
three-dimensional gait
kinematic parameters
