基于儿童悬吊运动系统的躯干控制训练治疗痉挛型脑性瘫痪的疗效研究

关键词：悬吊运动  痉挛型脑性瘫痪  躯干控制  表面肌电图

Keywords:sling exercise therapy  spastic cerebral palsy  trunk control  surface electromyography

摘要：

      摘要 目的：观察基于儿童悬吊运动(sling exercise therapy， SET)系统的躯干控制训练治疗痉挛型脑性瘫痪（以下简称脑瘫）的临床疗效。 方法：将符合入组标准的24例痉挛型脑瘫患儿随机分为两组，每组12例，对照组采用常规康复训练(45min/次)，治疗组在常规康复训练的基础上联合儿童悬吊运动训练系统进行躯干控制训练(20min/次)，两组均治疗1次/天、5天/周，共计3个月。观察患儿治疗前后粗大运动功能测试量表(gross motor function measure scale-88， GMFM-88)D区、E区评分及Berg平衡量表(Berg balance scale， BBS)评分变化情况；运用表面肌电图记录患儿腹直肌、竖脊肌、腹外斜肌、臀大肌的表面肌电信号，观察患儿肌肉协同收缩率(co-contraction ratio， CR)的变化；比较两组治疗后的临床疗效。 结果：治疗结束后，两组患儿在GMFM-D、GMFM-E、BBS评分及CR值上均有明显改善(P<0.01)；治疗组在改善GMFM-D、GMFM-E及BBS评分方面优于对照组(P<0.05)；治疗组在改善臀桥、坐位伸手取物时的CR值优于对照组(P<0.01)；治疗组粗大运动功能及平衡功能改善总有效率均高于对照组，差异具有显著性意义(P<0.01)。 结论：基于儿童悬吊运动系统的躯干控制训练可显著改善脑瘫患儿运动过程中肌肉的协调收缩能力，并提高其平衡、站立和行走能力。

Abstract:

      Abstract Objective：To observe the clinical efficacy of trunk control training based on children's sling exercise therapy (SET) in the treatment of spastic cerebral palsy. Method： The 24 children with spastic cerebral palsy who met the criteria of the group were randomly divided into two groups， 12 cases in each group. The control group was given routine rehabilitation training(45min/times)，while the treatment group was given additional children's sling exercise therapy for trunk control training besides routine rehabilitation training(20min/time). Both groups were treated for 3 months，1 times/day，5 days/week. The scores of the gross motor function measure(GMFM-88) D，E and Berg balance scale(BBS) were observed before and after treatment. The surface electromyography was used to record the surface electromyoelectric signals of the rectus abdominis， erector spinalis， external oblique abdominis and gluteus，and the changes of muscle co-contraction ratio(CR) were recorded. The clinical efficacy of the two groups was compared after treatment. Result： After treatment， GMFM-D， GMFM-E， BBS scores and CR value improved significantly in the two groups (P<0.01)， and the treatment group had better GMFM-D， GMFM-E and BBS scores than the control group (P<0.05) . The treatment group had better CR value of hip bridge and seat reach than the control group (P<0.01). The total effective rate of improving gross motor function and balance function in the treatment group was higher than that in the control group and the difference was statistically significant (P<0.01). Conclusion： Trunk control training based on children's sling exercise therapy can significantly improve the coordinated contraction ability of muscles， the balance ability, and standing and walking ability in children with cerebral palsy.