家庭康复结合机构康复对脑性瘫痪患儿早期康复疗效的影响

关键词：家庭康复  机构康复  脑瘫  早期康复

Keywords:family rehabilitation  institutions rehabilitation  cerebral palsy  early rehabilitation

摘要：

      摘要 目的：观察和探讨家庭康复结合机构康复对脑瘫患儿的早期康复疗效。 方法：将本中心2014年10月—2016年3月所有在训的42例6—45个月龄脑瘫患儿随机分为试验组和对照组，进行为期6个月的康复训练。对照组只进行机构康复，试验组除机构康复训练外，增加家庭康复，需进行家长康复指导和家庭康复记录、家长康复课程培训、家长心理辅导。采用儿童残疾量表（PEDI）、粗大运动功能测试量表（GMFM-66项）和Peabody精细运动评定量表（PDMS-FM）对两组患儿进行自理能力、移动、社交、粗大和精细运动功能的评定。 结果：试验组PEDI各项评分均较前有显著提高（P＜0.01），对照组在PEDI功能技巧自我照顾（P＜0.01）和照顾者辅助下的自我照顾（P＜0.05）方面较前有显著提高，在功能技巧和照顾者辅助下的活动和社交方面均无显著提高（P＞0.05），且试验组较对照组各项分值提高更显著（P＜0.05）。试验组和对照组PDMS-FM抓握和视觉运动、GMFM-66项得分均较前提高显著（P＜0.05），且试验组较对照组各项分值提高更显著（P＜0.05）。 结论：脑瘫患儿早期家庭康复结合机构康复使其在运动功能、生活自理能力、移动能力、社会功能的康复效果更显著。专业人员需制定方案，有效督导家庭康复的实施，并给予家长心理支持，才可使脑瘫患儿得到更有效的康复。

Abstract:

      Abstract Objective: To observe and explore the effect of family recovery combined with institutional recovery on the rehabilitation of children with cerebral palsy. Method: In October 2014—2016 March, all 42 children aged 6—45 months old with cerebral palsy in our center were randomly divided into experimental group and control group, for 6 months of rehabilitation training. The patients in the control group only accepted the institutional recovery, while the experimental group, besides the institutional rehabilitation training, accepted parental rehabilitation guidance, family rehabilitation records, parents rehabilitation course training, and parents' psychological guidance. The scales of PEDI, GMFM-66 and PDMS-FM were used to assess social, mobile,gross and fine motor function of two groups of children. Result: After treatment, PEDI scores in the experimental group were significantly increased than before (P＜0.01), the control group in PEDI (P＜0.01) and self care skills of caregivers assisted self care (P＜0.05) were significantly higher than before. However,the functional skills and caregiver assisted activities and social aspects were not improved significantly (P＞0.05). Moreover, the experimental group had more increment than the control group (P＜0.05). In the experimental group and the control group, PDMS-FM grasp and visual movement and GMFM-66 items scores were significantly higher than before (P＜0.05), and the scores in the experimental group were more significant than that in the control group (P＜0.05). Conclusion:Family recovery combined with institutional recovery for children with cerebral palsy in the early stage is more effective in rehabilitation of motor function, self-care ability, mobility and social function. Professionals need to develop programs to effectively supervise the implementation of family rehabilitation, and give parents psychological support, so that children with cerebral palsy can achieve more effective and more ideal rehabilitation outcome.