活动平板步行训练对不能独立行走的痉挛型脑瘫患儿运动技能的影响

摘要

Objective: To study the efficacy of locomotor treadmill training on gross motor skills and balance function in non-ambulatory children with spastic cerebral palsy (CP).Method: Forty patients (aged 24-60 months) of nonambulatory spastic diplegia were randomly divided into loco-motor treadmill training group (n=20) and control group (n=20). All patients were treated with regular rehabilitation training (lh per d, 5d weekly, 12 weeks), while patients in locomotor treadmill training group participated in individualized treadmill training (5-15min per d, 5 times weekly, 12 weeks). The modified Ashworth scale (MAS), Berg balance scale (BBS) and the gross motor function measure (GMFM) were performed at the beginning and at the end of 1st and 3rd month of the treatment course respectively.Result: At the end of 1st and 3rd month, the MAS scores decreased, BBS and GMFM scores in standing and walking function increased significantly in all patients of both groups (P<0.05). The BBS and GMFM scores of patients in locomotor treadmill training group were significantly higher than those in control group at each evaluating point (P<0.01), but the decrease of MAS scores had no statistical significance(P > 0.05).Conclusion: Locomotor treadmill training can improve gross motor function and balance function in children with CP, and accelerate earlier independent ambulation effectively.%目的:探讨活动平板步行训练对不能独立行走的痉挛型脑瘫患儿粗大运动及平衡功能的影响.方法:40例24-60个月龄具有站立(扶站或独站)功能但不能独立行走的双瘫患儿,随机分为活动平板步行训练治疗组(20例)及对照组(20例).治疗组及对照组均接受常规康复训练,治疗组在此基础上同时进行活动平板步行训练.康复训练每日1次,每次1h,每周5次,12周为一疗程.活动平板步行训练每日1次,每次5-15min,每周5次,12周为一疗程.分别于治疗前、治疗1个月和3个月进行下肢痉挛评分,包括改良Ashworth评级(MAS)、Berg平衡功能量表(BBS)及粗大运动功能量表(GMFM)的D区及F区百分比评估.结果:两组患儿治疗1个月和3个月后,MAS量化评分下降,Berg平衡功能和GMFM站立及走跑跳两大功能区评分均明显提高,与各自治疗前相比,差异有显著性意义(P＞0.05)；治疗组BBS评分、GMFM站立及走跑跳两大功能明显高于对照组(P＞0.0 1),而两组患儿相应评定点的MAS量化评分比较,差异无显著性意义(P＞0.05).结论:活动平板步行训练能提高痉挛性脑瘫患儿平衡功能及粗大运动功能,有利于促进脑瘫患儿独立行走.