Hufschmidt电刺激在痉挛型脑瘫儿童中的应用

关键词：脑瘫  痉挛  Hufschmidt电刺激  物理治疗

Keywords:cerebral palsy  spasticity  Hufschmidt electrical stimulation  physiotherapy

摘要：

      目的：观察 Hufschmidt电刺激对痉挛型脑瘫儿童的临床治疗效果，为临床使用提供客观依据。方法：14例痉挛型脑瘫患儿，随机分成A组和B组，A组患儿在前6周进行干预期治疗，后6周进行对照期治疗。B组患儿在前6周进行对照期治疗，后6周进行干预期治疗 。在干预期行Hufschmidt电刺激和常规物理治疗，对照期只行常规物理治疗。患儿入选时、治疗6周、治疗12周时分别评估被动关节活动角度、Berg平衡量表评分、粗大运动功能测量评分(gross motor function mesaure,GMFM)、10m步行时间各项功能。结果：患儿在干预期腘窝角、内收肌角的改变量明显大于对照期，差异有显著性意义（P<0.05），踝背伸角改变量的差异无显著性意义（P>0.05）；Berg平衡量表总分改变量明显高于对照期，差异有显著性意义（P<0.05）；GMFM的C区、D区、E区及总分改变量明显高于对照期，差异有显著性意义（P<0.05），GMFM的A区、B区改变量的差异无显著性意义（P>0.05）； 10m步行时间改变量明显高于对照期，差异有显著性意义（P<0.05）。结论：Hufschmidt电刺激治疗能有效地改善关节活动范围、提高平衡能力、粗大运动功能和步行能力，可以作为治疗痉挛型脑瘫的一种方法。

Abstract:

      Objective:To investigate the effect of Hufschmidt electrical stimulation(HES) in children with spastic cerebral palsy(SCP). Method: All 14 children were randomly divided into A and B groups. The children of A group were treated with Hufschmidt electrical stimulation and physiotherapy for the first 6 weeks(HES period), only physiotherapy for the subsequent 6 weeks(observation period). The children of B group were treated with physiotherapy for the first 6 weeks(observation period), then Hufschmidt electrical stimulation and physiotherapy for the subsequent 6 weeks(HES period). All children were evaluated in terms of tests of gross motor function measure score(GMFM), the Berg Balance Scale(BBS), passive range of motion(PROM), and 10-metre walk time at the start and after 6 to 12 weeks. Result: There were significant improvements of section C, D, E of the gross motor function measure score, the Berg Balance Scale, the Popliteal angle, adductor angle ,and 10-metre walk time for variation in HES period（P<0.05）. However, no significant improvement was found in section A, B of gross motor function measure score, ankle dorsiflexion（P>0.05）.Conclusion:Hufschmidt electrical stimulation combined with physiotherapy improves gross motor function, muscle tone, range of motion, and balance ability in spastic cerebral palsy, so it can be an effective therapeutic technique in children with spastic cerebral palsy.