触发点针刺联合下肢机器人训练对脑性瘫痪患儿腘绳肌痉挛疗效的临床观察

关键词：脑性瘫痪  触发点  针刺  下肢机器人  三维步态分析

Keywords:cerebral palsy  trigger point  acupuncture  lower limb robot  three-dimensional gait analysis

摘要：

      摘要 目的：探讨触发点针刺联合下肢机器人训练对痉挛型双瘫的脑瘫患儿腘绳肌痉挛改善的影响。 方法：将70例痉挛型双瘫的脑瘫患儿按随机数字表法分为观察组（35例，脱落1例）和对照组（35例，脱落3例）。两组均予康复治疗、传统针灸治疗等常规治疗，对照组在常规治疗的基础上给予下肢机器人训练，每日1次，每周5次，连续治疗4周；观察组在常规治疗的基础上给予触发点针刺联合下肢机器人训练，每日1次，每周5次，连续治疗4周。治疗前、治疗四周后分别采用改良Ashworth量表（MAS）、三维步态分析、粗大运动功能测试量表（GMFM）进行评定。 结果：与治疗前比较，两组患儿治疗后MAS评分下降，平均速度、步频提高，跨步长、步长提高，膝关节活动度提高，GMFM-D区、E区评分提高（P<0.05）；治疗后观察组MAS评分、平均速度、步频、膝关节活动度、GMFM-D区、E区评分的改善均优于对照组（P<0.05）。 结论：触发点针刺联合下肢机器人训练有助于缓解脑瘫患儿腘绳肌痉挛，改善患儿步态及站立、步行功能。

Abstract:

      Abstract Objective： To investigate the effect of trigger point acupuncture combined with lower limb robot training on the improvement of hamstring spasm in children with spastic diplegia and cerebral palsy. Method： Seventy children with cerebral palsy and spastic diplegia were divided into observation group (35 cases， 1 case dropped) and control group (35 cases， 3 cases dropped) according to a random number table. Both groups were treated with conventional treatments including rehabilitation treatment and traditional acupuncture treatment. The control group was giving lower limb robots training on the basis of conventional treatment, once a day， and 5 times a week for 4 consecutive weeks. The observation group was given trigger point acupuncture combined with lower limb robot training on the basis of conventional treatment, once a day， and 5 times a week for 4 consecutive weeks. Before and after 4 weeks treatment， the modified Ashworth Scale (MAS)， three-dimensional gait analysis， gross motor function measure (GMFM) were used for evaluation. Result： Compared with those before treatment，there were decreased MAS scores, increased average speed and cadence，increased step length and step length，increased the knee range of motio，increased GMFM-D and GMFM-E after treatment (P<0.05). After treatment, the improvements of MAS score， average speed， stride frequency，knee range of motion，GMFM-D and GMFM-E in the observation group were better than those in the control group (P<0.05). Conclusion： Trigger point acupuncture combined with lower limb robot training can relieve hamstring spasm in children with cerebral palsy and improve their gait， standing and walking function.