运动疗法对小儿脑瘫患者步态的改善研究

摘要

目的：探讨在佩戴矫形鞋的基础上对痉挛型脑瘫患儿进行减重步行训练和综合性康复治疗的疗效。方法：将50名年龄在3~5岁的大龄痉挛型脑瘫患儿分为治疗组和对照组，治疗组在佩戴矫形鞋的情况下进行减重步行训练和综合性康复治疗，对照组进行综合性康复治疗。治疗时间3个月，在治疗前后分别对两组进行下肢运动功能和步行能力评估，评估使用粗大运动功能评分（GMFM）、Berg平衡评分和粗大运动功能分级（GMFCS）。结果：治疗组步态改善明显于对照组，下肢运动功能明显提高；GMFM评分、Berg平衡评分以及GMFCS显著增加，与治疗前相比，有显著差异（P<0.05）；对照组虽也有改善，但不如治疗组明显。结论：痉挛型脑瘫患儿在佩戴矫形鞋的基础上进行减重步行训练，并结合综合性康复治疗，对患儿下肢运动功能及步态的改善效果明显优于单纯综合性康复治疗的疗效。%Objectives:to probe into the recovery treatment results of the weight-loss walking training and synthetic treating to the spastic brain paralysis infants with orthopedic shoes,this paper comparatively experiments the curative effect. Methods: A total 50 children with spastic cerebral palsy(age from 3~5 )were divided into 2 groups randomly: randomly:therapy group and control group. Therapy group got weight relief training with orthopedic footwear and general rehabilitation therapy,while control group only got general rehabilitation. Pre therapy and post—therapy,lower limb motor function and walking ability assessment were evaluated on all children. Gross Motor Function Measure(GMFM),Berg balance score and Gross Motor Function Classification System(GMFCS). Results:The assessment result showed that, after therapy,both the gait and the motor ability improved more obviously in therapy group. GMFM,Berg balance score and GMFCS increased significantly t(P<0.05),and the difference between the two groups was statistical significant. Conclusions: On the base of the general rehabilitation,weight relief training with orthopedic footwear can effectively improve and elevate the gait all(t motor ability in the cerebral palsy children with spasm.