摘要
目的探讨神经肌肉电刺激(NMES)结合肌力训练对痉挛型脑性瘫痪(脑瘫)患儿运动功能的影响。方法脑瘫患儿86例。年龄4.0～5.8岁。通过计算机分层后随机分为研究组(44例)和对照组(42例)。二组患儿均接受以Bobath技术为主的神经发育学疗法。研究组患儿在此基础上增加NMES结合肌力训练,NMES采用电刺激仪,4个表面电极放置于患侧足背伸肌群肌腹处给予电刺激,20min/次;肌力训练根据脑瘫患儿的运动功能状况,结合运动学理论、运动学习理论和神经发育学理论等进行针对性训练;1次/d,5次/周,连续6周。之后指导家长实施家庭康复治疗。治疗前,治疗6、12周随访时进行以下评定:(1)综合痉挛量表(CSS);(2)粗大运动功能量表(GMFM)中的D和E二项;(3)步行速度。结果二组患儿的性别、年龄、粗大运动功能分级水平、痉挛型偏瘫和双瘫的患儿例数差异均无统计学意义(Pa>0.05)。治疗前,二组患儿的CSS评分、GMFM评分及步行速度比较差异均无统计学意义(Pa>0.05);治疗6、12周CSS评分、GMFM评分及步行速度,与治疗前比较,差异均有统计学意义(Pa<0.01)。治疗6、12周,二组患儿CSS评分、GMFM评分及步行速度组间比较,差异均有统计学意义(Pa<0.05)。结论NMES结合肌力训练能更好地提高痉挛型脑瘫患儿的运动功能。
Objective To investigate the effects of neuromuscular electrical stimulation （NMES） combined with strength training on motor function in children with spastic cerebral palsy （CP）. Methods Eighty-six children with CP aged 4.0 to 5.8 years old were randomly divided into study group （n = 44） and control group （n = 42）. All patients received neurodevelopmental therapy. The study group were applied NMES combined with strength training. NMES devices were used and the surface electrodes were applied on the ankle dorsiflexor in the affected lower extremity. NMES lasted for 20 rain per session. Strength training was administered in accordance with subjects＇ functional level, kinetic theory, motor learning theory, and neurodevelopmental theory＇. It lasted for 6 weeks one time daily, 5 times weekly. After 6 weeks, the program was continued in the familys of the subjects. Clinical assessments included composite spasticity scale （CSS） , D and E dimensions of the gross motor function measure （GMFM） , and walking velocity （WV）were performed before treatment, and the 6 weeks and 12 weeks after treatment. Results No statistically significant differences were found in age, gender, number of the hemiplegic and diplegic CP, level of gross motor function classification system, as well as chnical assessments （CSS, GMFM and WV ）before treatment between 2 groups （Pa〉0.05）. Compared with the CSS, GMFM and WV before treatment, there were statistically difference after 6 and 12 weeks treatment in two groups（Pa〈0.01 ）. Furthermore, the differences of CSS, GMFM and WV at 6,12 weeks after treatment were statistically significant between the 2 groups（Pa〈0.05 ）. Conclusion NMES combined with strength training can improve the functional performance on children with spastic CP.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2008年第12期911-912,944,共3页
Journal of Applied Clinical Pediatrics
关键词
神经肌肉电刺激
肌力训练
脑性瘫痪
痉挛
运动功能
neuromuscular electrical stimulation
strength training
cerebral palsy
spastieity
motor function
