Peabody运动发育量表2干预方案结合核心稳定性训练对痉挛型偏瘫的脑性瘫痪患儿上肢功能及运动功能独立性的影响

关键词：脑性瘫痪  Peabody运动发育量表  核心稳定性  功能独立性

Keywords:cerebral palsy  peabody developmental motor scale  core stability  the functional independence

摘要：

      摘要 目的：探讨PDMS-2干预方案结合核心稳定性训练对痉挛型偏瘫的脑瘫患儿上肢功能及运动功能独立性的影响。 方法：将60例痉挛型偏瘫的脑瘫患儿随机分为常规组、训练组、干预组，每组均20例，分别于治疗前及治疗3个月后、6个月后进行下列评估：Peabody精细运动发育量表（PDMS-2 FM）、改良Ashworth、儿童功能独立性评定量表（WeeFIM）运动功能项。 结果：①PDMS-2 FM：治疗3个月后，常规组、训练组、干预组评分均较本组治疗前增加，差异均有显著性意义（P=0.015，0.001，0.000），干预组、训练组评分均较常规组增加，差异均有显著性意义（P=0.000，0.004），干预组、训练组间差异无显著性意义（P=0.390）；治疗6个月后，常规组、训练组、干预组评分均较本组治疗3个月时增加（P=0.014，0.000，0.000），干预组评分较训练组增加，差异有显著性意义（P=0.007）。②改良Ashworth：各组治疗前后及治疗后同一测评点组间比较，差异均无显著性意义。③WeeFIM运动功能项：治疗3个月后，干预组、训练组评分均较本组治疗前增加，差异均有显著性意义（P=0.015，0.035），各组间比较差异无显著性意义；治疗6个月后，常规组、训练组、干预组评分均较本组治疗前增加，差异均有显著性意义（P=0.008，0.000，0.000），干预组、训练组评分均较本组治疗3个月增加，差异均有显著性意义（P=0.001，0.005），干预组、训练组评分均较常规组增加，差异均有显著性意义（P=0.002，0.045）。 结论：PDMS-2干预方案结合核心稳定性训练能有效改善痉挛型偏瘫的脑瘫患儿上肢运动功能，促进精细运动发育，提高其运动功能独立性。

Abstract:

      Abstract Objective: To investigate the influence of PDMS-2 intervention scheme combining with core stability training on the function of upper limb and the independence of movement function of children with spastic hemiplegia. Method: Sixty children with spastic hemiplegia were randomly divided into normal group, training group and intervention group, 20 cases in each group. To evaluate the therapeutic effect before and 3 months after the treatment, 6 months after the treatment: including the Peabody developmental motor scale about fine motor (PFMS-2 FM), modified Ashworth assessment, the motor function part of the functional independence measure for children (WeeFIM). Result: ① PDMS-2 FM: The score of normal group in 3 months after treatment was higher than that before the treatment， with statistical significance (P=0.015). The score of the intervention group and training group increased significantly compared with that before the treatment each group and that of the normal group 3 months after treatment (P＜0.01). The score of 6 months after treatment significantly increased than that in 3 months after treatment. The score of the intervention group increased significantly compared with that of the training group 6 months after treatment (P=0.007). ② Modified Ashworth assessment: The scores before and after the treatment in each group were not significantly different, the same as it between different groups in the same training time. ③ WeeFIM: The score of intervention group and training group 3 months after treatment was higher than that before the treatment, each difference had statistically significant (P=0.015, 0.035). The score of 6 months after treatment significantly increased than that before treatment in each group (P＜0.01). The score at 6 months was higher than that at 3 months after treatment in the intervention group and training group (P=0.001, 0.005). The score of the intervention group and the training group all increased significantly compared with that of the normal group 6 months after treatment (P=0.002, 0.045). Conclusion: PDMS-2 intervention scheme combining with core stability training could effectively improve the movement function of the upper limb in the children with spastic hemiplegia, promote the development of fine motor function, enhance the independence of the movement function.