任务导向性训练对痉挛型偏瘫儿童上肢功能的效果
Effect of Task-oriented Training on Upper Limb Function in Children with Spastic Hemiplegic
-
摘要: 目的 观察任务导向性双侧上肢训练对脑瘫痉挛型偏瘫型患儿上肢功能恢复的效果.方法 27例36岁的脑瘫痉挛型偏瘫患儿随机分为对照组 (n=13) 和治疗组 (n=14) 进行训练.对照组进行常规作业治疗, 治疗组在对照组基础上增加任务导向性双侧上肢训练.治疗持续10周.治疗前后均采用Peabody运动发育量表-2 (PDMS-2) 及Upper Limb Physician’s Rating Scale, ULPRS进行疗效评估.结果 2组患儿经过治疗后, Peabody运动发育量表中的抓握功能和视觉-运动整合评分均较治疗前提高 (P<0.05) , 实验组评分高于对照组 (P<0.05) , 评分增加程度比较也具有统计学意义 (P<0.05) ;2组患儿治疗后ULPRS评分均有提高 (P<0.05) , 治疗组较对照组评分差异无统计学意义 (P>0.05) , 评分增加程度差异无统计学意义 (P>0.05) .结论 任务导向性双侧上肢训练能够促进偏瘫型脑瘫患儿偏瘫侧上肢及手功能的恢复.Abstract: Objective To investigate the effectiveness of task-oriented bilateral arm training on upper limb function in children with spastic hemiplegia. Methods 27 children within 4-6 years with spastic hemiplegic were randomly divided into control group (n=13) and experiment group (n=14) . The children in control group received routine occupational therapy. The bilateral arm task-oriented training was added for children in experiment group. The Peabody development motor scale-2 (PDMS-2) and Upper Limb Physician's Rating Scale (ULPRS) were used to assess the upper limb function before and after 10 weeks intervention. Results After treatment, the scores of grasping function and visual-motor integration in PDMS-2 were significantly higher than those before treatment (P<0.05) , and the scores of experimental group werehigher than that of control group (P <0.05) , and the difference of the added value between two groups were statistically significant (P<0.05) .The ULPRS scores of both groups increased after treatment (P<0.05) , scores between the treatment group and the control group were not statistically significant (P>0.05) , and the difference of the added value between two groups was not statistically significant (P>0.05) . Conclusion The task-oriented bilateral arm training can promote recovery for upper limb and hand function in children with spastic hemiplegia compared with routine occupational therapy.
-
Key words:
- Cerebral palsy /
- Spastic hemiplegia /
- Task-oriented training /
- Upper limb functions
-
[1]黄真.“运动学习”相关理论及其在脑性瘫痪康复中的应用[J].中国康复医学杂志, 2007, 22 (7) :652-655. [2] [2]LVEY F M, HAFER-MACKO C E, MACKO R G.Task-oriented treadmill exercise training in chronic hemipareticstroke[J].J Rehabil Res Dev, 2008, 45 (2) :249-259. [3]张大威, 叶祥明, 林坚, 等.下肢任务导向性训练对慢性期脑卒中患者步行能力的影响[J].中国康复医学杂志, 2011, 26 (8) :768-770. [4]李鑫, 庞伟, 范艳萍, 等.任务导向性训练对痉挛型脑瘫患儿移动功能疗效研究[J].中国儿童保健杂志, 2015, 23 (5) :556-558. [5]庞伟, 李鑫, 范艳萍, 等.任务导向性训练对痉挛型脑性瘫痪儿童粗大运动功能及步行功能的疗效[J].中国康复医学杂志, 2016, 31 (1) :30-34. [6]张春阳, 庞伟, 范艳萍, 等.任务导向性训练对痉挛型脑性瘫痪儿童的平衡控制影响[J].中国中西医结合儿科学, 2014, 6 (2) :164-166. [7]中国康复医学会儿童康复专业委员会, 中国残疾人康复协会小儿脑性瘫痪康复专业委员会, 《中国脑性瘫痪康复指南》编委会.中国脑性瘫痪康复指南 (2015) :第一部分[J].中国康复医学杂志, 2015, 30 (7) :747-754. [8] [8]VAN S, SIEBES R, DALLMEIJER A, et al.Developmentof social functioning and communication inschool-aged (5-9years) children with cerebral palsy[J].Res Dev Disabil, 2013, 34 (12) :4485-4494. [9] [9]ZIELINSKIL M, JONGSMA M L, BAS C M, et al.Unravelling developmental disregard in children with unilateral cerebral palsy by measuring event-related potentials during a simpleand complex task[J].BMC Neurol, 2014, 14:6. [10] [10]SAKZEWSKIL, ZIVIANIJ, BOYDR.Therelationshipbetweenunimanualcapacity and bimanualperformanceinchildrenwithcongenitalhemiplegia[J].Dev Med Child Neurol, 2010, 52 (9) :811-816. [11] [11]CHARLES J, GORDON A M.Development of handarm bimanual intensive therapy (HABIT) for improving bimanual coordination in childrenwith hemiplegic cerebral palsy[J].Dev Med Child Neurol, 2006, 48 (11) :931-936. [12] [12]GORDON A M, HUNG Y C, BRANDAO M, et al.Bimanual training and constraint-induced movement therapy in children with hemiplegic cerebral palsy:a randomized trial[J].Neurorehabil Neural Repair, 2011, 25 (8) :692-702. [13] [13]BLEYENHEUFT Y, ARNOULD C, BRANDAO M B, et al.Hand and arm bimanual intensive therapy including lower extremity (habit-ile) in children with unilateral spastic cerebral palsy:a randomized trial[J].Neurorehabil Neural Repair, 2015, 29 (7) :645-657. [14]董尚胜, 陈艳娟, 李业荣.A型肉毒毒素注射在脑性瘫痪儿童上肢中的临床应用进展[J].中国康复医学杂志, 2017, 32 (8) :966-969. [15]孙瑞雪, 姜志梅, 徐磊, 等.手-臂双侧强化训练对偏瘫脑瘫儿童上肢功能及日常活动能力的影响[J].中国儿童保健杂志, 2016, 24 (1) :108-110. [16]李倩, 侯梅, 张强, 等.手-臂双侧徒手强化训练治疗脑瘫患儿上肢功能障碍[J].中国康复, 2014, 29 (3) :179-182. -
点击查看大图
计量
- 文章访问数: 2622
- HTML全文浏览量: 995
- PDF下载量: 152
- 被引次数: 0
下载:
