体外冲击波用于改善痉挛型脑性瘫痪患儿蹲伏步态的临床研究

关键词：脑性瘫痪  体外冲击波  蹲伏步态

Keywords:cerebral palsy  extracorporeal shock wave  crouch gait

摘要：

      摘要 目的：应用体外冲击波治疗痉挛型脑瘫患儿蹲伏步态的疗效分析。 方法：30例痉挛性双瘫患儿随机分为治疗组和对照组（每组15例），治疗组加用冲击波治疗，治疗前和治疗后3个月对2组患儿的膝、踝关节的最大角度和关节活动度、肌张力、步长、步速和粗大运动功能评分（GMFM）进行评定。 结果：治疗3个月后，两组患儿踝关节的关节活动度、膝关节和踝关节屈曲最大角度和最小角度都明显改善（P<0.05）；腘绳肌群和小腿三头肌群的肌张力明显下降（P<0.05），但治疗组改善更明显；两组患儿GMFM评分、步速、步长均有改善（P＜0.05），但治疗组效果更明显。 结论：体外冲击波可以降低脑瘫患儿腘绳肌、小腿三头肌肌张力，能够改善患儿的蹲伏步态。

Abstract:

      Abstract Objective: To investigate the therapeutic effect of extracorporeal shock wave therapy（ESWT） on crouch gait in children with spastic cerebral palsy. Method:Thirty cerebral palsy children with spastic diplegia were enrolled in this randomized clinical trial and divided into treatment group and control group. Both of the two groups received physiotherapy for 3 months, and the treatment group take ESWT additionally. Knee and ankle joint maximum angles and joint activities degree, step length and walking speed and gross motor function score were assessed before and 3 months after treatment, respectively. Result: After 3 months treatment,and comparing to the control group, range of motion of ankle joint, the maximum knee flexion and extension angle of knee and ankle in treatment group improved more significantly (P<0.05), GMFM score and walking speed, step length improved (P<0.05) in both group, but more significantly in treatment group. Conclusion: Extracorporeal shock wave therapy can decrease the muscle tone of the hamstring and calf muscles in children with cerebral palsy, and make a positive and significant change in their crouch gait.