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解清云,侯 梅,赵建慧,李 君,于 荣.核心稳定训练对痉挛型脑性瘫痪患儿运动功能的影响[J].中国康复医学杂志,2014,29(6):528~532
核心稳定训练对痉挛型脑性瘫痪患儿运动功能的影响    点此下载全文
解清云  侯 梅  赵建慧  李 君  于 荣
青岛大学医学院,青岛市登州路38号,266021
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摘要:
      摘要 目的:探讨核心稳定训练对痉挛型脑性瘫痪(简称脑瘫)患儿运动功能的影响。 方法:2012年6月—2013年6月入住青岛市妇女儿童医院神经康复科的痉挛型双侧性瘫痪的脑瘫患儿,诊断及分型明确、粗大运动功能测定(GMFCS)为Ⅰ—Ⅱ级、能够理解并听从指令、入组前6个月内未行A型肉毒毒素神经阻滞术或矫形手术的患儿60例,按年龄、脑瘫类型及GMFCS分级水平匹配原则进行随机分组。在基础治疗的同时,实验组进行常规PT训练1次(30min)和核心稳定训练1次(30min),对照组进行常规PT训练2次(30min/次),所有治疗项目均为每周5次,每次持续30min,3个月为1个疗程。采用粗大运动功能测定(GMFM)中的各能区评分、10m步行测试(10MWT)、上下楼梯测试(TST)分别评估两组患儿训练前后的粗大运动功能和步行情况,并对结果进行组内和组间比较。 结果:3个月后对照组和实验组患儿的A、B、C区评分均无明显提高(P>0.05),D区、E区评分均较训练前提高(P<0.05)、最适步速独走10m所用时间(代表步速)、和上下5层楼梯时间,两组均亦减少(P<0.05),但实验组明显优于对照组(P<0.05);而独走10m所需步数(代表跨步长)两组治疗后较治疗前均减少(P<0.05),且两组间无明显差异性(P>0.05)。 结论:核心稳定训练联合常规PT训练更有利于提高痉挛型双侧瘫痪的脑瘫患儿粗大运动功能、行走最适步速及上下楼梯速度,但对提高步长两组间无明显差异性。
关键词:脑性瘫痪  核心肌群  核心稳定性
Effects of core stability training on gross motor function of children with spastic cerebral palsy    Download Fulltext
Qingdao University, Medical College, 266021
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Abstract:
      Abstract Objective:To investigate the effects of core stability training on gross motor function of children with spastic cerebral palsy. Method:The study included a sample of 60 children with spastic bilateral cerebral palsy who had been treated in the department of neurology and rehabilitation of Qingdao woman and children's hospital from June 2012 to June 2013.Inclusion criteria were as follows: Children with conclusive diagnosis and types of cerebral palsy and aged at least 2 years old; gross motor function classification systems(GMFCS) levels Ⅰ—Ⅱ,being able to understand and obey language orders; no history of botulinum toxin A injection and/or orthopedic surgery in the past 6 months. All participants were randomly divided into 2 groups according to the matching rules among the ages,types and GMFCS levels.Under the same fundamental training programs,the experimental group(n=30) received a 30min core stability training and a 30min routine physical therapy every day, the control group received routine physical therapy twice (30min once).All rehabilitation training were 30min per time,5 times per week. Before and 3 months after training,they were assessed with A,B,C,D and E domains of gross motor function measure(GMFM),the timed 10 meter walk test(10MWT) and the timed stair test(TST).The data were analyzed using computer statistically software SPSS 17.0 . Result:After 3 months,The scores of A,B and C domains in both groups didn't increased(P>0.05),but the scores of D and E domains in both groups increased markedly(P<0.05)and the time of 10MWT and TST decreased simultaneously(P<0.05),especially in experimental group(P<0.05). In both groups step numbers decreased(P<0.05) and there was no significant difference between two groups(P>0.05). Conclusion:The core stability training combined with routine physical therapy could improve the gross motor function of children with spastic bilateral cerebral palsy more effectively than that with simply routine physical therapy,including to increase the speed and decrease the time of walking and going stairs,but there was no difference in increasing step length.
Keywords:cerebral palsy  core muscle  core stability
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