自制踝足矫形带对痉挛型偏瘫脑性瘫痪足下垂患儿下肢运动功能的疗效

摘要

目的：观察自制自制踝足矫形带对痉挛型偏瘫脑瘫足下垂患儿下肢运动功能的疗效。方法24例痉挛型偏瘫脑瘫足下垂患儿随机分为观察组和对照组各12例。两组患儿均行常规康复训练，对照组行步态训练，观察组佩戴自制踝足矫形带行步态训练，共12周。治疗前后分别采用腓肠肌改良Ashworth量表(MAS)、踝关节主动背屈活动度(ROM)和粗大运动功能测量(GM-FM-88)D区(站立)、E区(走跑跳)进行评定。结果治疗后，两组MAS评分明显降低(P<0.01)，观察组低于对照组(P<0.05)；两组ROM、GMFM-88的D区和E区评分均明显高于治疗前(P<0.01)，观察组高于对照组(P<0.05)。结论佩戴自制踝足矫形带行步态训练能进一步降低痉挛型偏瘫脑瘫患儿患侧的腓肠肌张力，增加踝关节活动度，提高下肢运动功能。%Objective To observe the effect of homemade ankle-foot orthopedic band on motor function of lower extremities in children with foot drop post spastic hemiplegic cerebral palsy (CP). Methods 24 spastic hemiplegic CP children were randomly divided into observa-tion group (n=12) and control group (n=12). Both groups accepted roution rehabilitation training. The control group accepted walking train-ing, and the observation group accepted walking training wearing the homemade ankle-foot orthopedic band, for 12 weeks. They were as-sessed with modified Ashworth Scale (MAS) of gastrocnemius, range of motion (ROM) of ankle active dorsiflexion, and D and E domains of Gross Motor Function Measure (GMFM-88) before and after treatment. Results The score of MAS significantly decreased in both groups after treatment (P<0.01), and decreased more in the observation group than in the control group (P<0.05). ROM and scores of D and E do-mains of GMFM-88 significantly increased in both groups after treatment (P<0.01), and increased more in the observation group than in the control group (P<0.05). Conclusion Walking training with the homemade ankle-foot orthopedic band may further decrease the muscle tone of gastrocnemius, increase the active range of motion of ankle and improve the motor function of lower extremities in children with foot drop post spastic hemiplegic CP.