家庭康复运用CIMT对偏瘫型脑性瘫痪患儿上肢功能恢复的影响

摘要

Object To observe the effect of home-based constraint-induced movement therapy (CI-MT) on upper limb function in children with hemiplegic cerebral palsy. Method Sixty-two patients with hemiplegic cerebral palsy were divided into CIMT group and control group. Both groups were treated with com-mon rehabilitation training,with an extra CIMT training in the former group. The effects were evaluated and compared with fugl-meyer assessment-upper extremity (FMA-UE ),motor assessment scale-upper extremity (MAS-UE),upper extremity function test (UEFT),barthel index were applied to evaluate upper limb func-tion and activity of daily living in two groups before and after treatment. Results After 1 0 weeks of treatment, the scores of FMA-UE,MAS-UE,UEFT and Barthel index of both groups were improved obviously (P<0.05 ). The treatment effect of CIMT group was significantly better than that of the control group (FMA-UE:31.44 ±1 2.26 vs. 25.52 ±1 0.71;MAS-UE:5.96 ±4.50 vs. 3.65 ±4.48;UEFT:53.35 ±5.43 vs.42.44 ±2.10;Barthel index:59.48 ±5.45 vs. 56.41 ±4.75)(P<0.05). Conclusion CIMT is helpful to improve the upper limb function of children with hemiplegic cerebral palsy.%目的：探讨家庭康复中运用强制性诱导运动疗法（CIMT）对偏瘫型脑瘫患儿上肢功能恢复的影响。方法将偏瘫型脑瘫患儿62例分为CIMT组与对照组，两组均接受普通康复训练， CIMT组在此基础上还接受CIMT治疗。采用以下量表对治疗疗效进行评定并比较两组结果，包括Fugl-Meyer运动功能评定量表（FMA）上肢部分（FMA-UE）、运动功能评估量表（MAS）上肢部分（MAS-UE）、Carroll上肢功能试验（UEFT）及日常生活活动能力（ADL）量表（Barthel指数）。结果治疗10周后，两组的 FMA-UE、MAS-UE、UEFT 评分及 Barthel 指数均较治疗前提高（P均＜0.05），且CIMT组疗效优于对照组（FMA-UE：31.44±12.26 vs.25.52±10.71；MAS-UE：5.96±4.50 vs.3.65±4.48；UEFT：53.35±5.43 vs.42.44±2.10；Barthel指数：59.48±5.45 vs.56.41±4.75）（P均＜0.05）。结论家庭康复中运用CIMT有助于偏瘫型脑性瘫痪患儿上肢功能的恢复。