头针配合MOTOmed虚拟情景训练对痉挛型脑瘫患者粗大运动功能及ADL的影响

摘要

目的：观察头针配合MOTOmed虚拟情景训练对痉挛型脑瘫患者粗大运动功能及ADL的影响。方法将30例符合纳入标准的痉挛型脑瘫患者随机分为治疗组12例和对照组18例。对照组采用常规康复治疗，治疗组在对照组治疗基础上采用头针配合MOTOmed虚拟情景训练治疗。两组患者治疗前后分别采用改良的Ashworth量表(MAS)测定内收肌、腓肠肌和腘绳肌肌张力，采用粗大运动量表测量粗大运功功能，采用 ADL 评定量表进行日常生活活动能力评定。结果治疗组治疗后内收肌、腘绳肌及腓肠肌肌张力与同组治疗前比较，差异均具有统计学意义(P＜0.05)。对照组治疗后内收肌肌张力与同组治疗前比较，差异具有统计学意义(P＜0.05)。治疗组治疗后腘绳肌及腓肠肌肌张力与对照组比较，差异均具有统计学意义(P＜0.05)。治疗组治疗后足背屈角及腘窝角度数与同组治疗前比较，差异均具有统计学意义(P＜0.05)。对照组治疗后股角度数与同组治疗前比较，差异具有统计学意义(P＜0.05)。治疗组治疗后足背屈角及腘窝角度数与对照组比较，差异均具有统计学意义(P＜0.05)。两组治疗后GMFM评分及ADL评分与同组治疗前比较，差异均具有统计学意义(P＜0.05)。治疗组治疗后GMFM评分及ADL评分与对照组比较，差异具有统计学意义(P＜0.05)。结论头针配合MOTOmed虚拟情景训练是一种治疗痉挛型脑瘫的有效方法，能改善患者粗大运动功能及ADL评分。%Objective To investigate the effect of scalp acupuncture plus MOTOmed virtual scene training on gross motor function and ADL in patients with spastic cerebral palsy. Methods Thirty patients with spastic cerebral palsy meeting the inclusion criteria were randomly allocated to a treatment group of 12 cases and a control group of 18 cases. The control group received routine rehabilitation therapy and the treatment group, scalp acupuncture plus MOTOmed virtual scene training in addition. Adductor, gastrocnemius and hamstring muscle tensions were determined using the Modified Ashworth Scale (MAS), gross motor function was measured using the Gross Motor Scale and the activities of daily living were assessed using the ADL in the two groups of patients before and after treatment. Results There were statistically significant pre-/post-treatment differences in adductor, gastrocnemius and hamstring muscle tensions in the treatment group (P<0.05). There was a statistically significant pre-/post-treatment difference in adductor muscle tension in the control group (P<0.05). There were statistically significant post-treatment differences in gastrocnemius and hamstring muscle tensions between the treatment and control groups (P<0.05). There were statistically significant pre-/post-treatment differences in the foot dorsiflexion angle and popliteal fossa angle in the treatment group (P<0.05). There was a statistically significant pre-/post-treatment difference in the posterior femoral angle in the control group (P<0.05). There were statistically significant post-treatment differences in the foot dorsiflexion angle and popliteal fossa angle between the treatment and control groups (P<0.05). There were statistically significant pre-/post-treatment differences in the GMFM score and the ADL score in the two groups (P<0.05). There were statistically significant post-treatment differences in the GMFM score and the ADL score between the treatment and control groups (P<0.05). Conclusions Scalp acupuncture plus MOTOmed virtual scene training is an effective way to treat spastic cerebral palsy. It can improve gross motor function and the ADL score in the patients.