芭蕾舞训练对痉挛型脑性瘫痪儿童步行参数的影响

关键词：脑性瘫痪  芭蕾舞  三维步态分析  步行参数  步态偏差指数

Keywords:cerebral palsy  ballet  three-dimensional gait analysis  walking parameters  gait deviation index

摘要：

      摘要 目的：探讨芭蕾舞训练对痉挛型脑性瘫痪（CP）儿童步行参数的影响。 方法：选取24例脑性瘫痪儿童，按照相近年龄、相同性别、相同GMFCS分级进行1∶1配对后随机分组，即试验组12例，对照组12例。试验组采用芭蕾舞训练结合常规康复治疗，对照组采用常规康复治疗，干预时间均为3个月。运用三维步态分析技术采集受试者干预前、后的运动学、动力学参数、步态偏差指数（GDI），分析两组疗效差异。 结果：两组在治疗前运动学、动力学、GDI差异无显著性意义。两组治疗后比较：运动学参数：试验组干预前后，支撑相双侧髋关节最大屈曲角度、双侧髋关节最大伸展角度，摆动相右侧髋关节最大屈曲角度、右侧髋关节最大伸展角度及右侧踝关节最大跖屈角度，差异具有显著性意义（P＜0.05）。动力学参数：试验组干预前后，支撑相左侧踝关节最大跖屈力矩、左侧踝关节吸收震荡能力，差异具有显著性意义（P＜0.05）；两组干预后：支撑相右侧踝关节最大跖屈力矩、右侧髋关节最大做功、左侧最大地反力、双侧踝关节吸收震荡能力，差异具有显著性意义（P＜0.05）。 结论：芭蕾舞训练结合常规康复治疗可明显改善痉挛型CP儿童髋伸展肌群、髋屈曲肌群及足跖屈肌群功能，疗效优于常规康复训练。本研究为今后CP儿童的舞蹈治疗提供了新思路。

Abstract:

      Abstract Objective： To investigate the influence of ballet training on walking parameters of children with spastic cerebral palsy. Method： A total of 24 children with cerebral palsy were selected and randomly grouped by 1∶1 matching according to similar age， same sex and GMFCS grading，namely 12 cases in the experimental group and 12 cases in the control group. The experimental group received ballet training combined with conventional rehabilitation treatment，and the control group received conventional rehabilitation treatment. The intervention time was 3 months. Three-dimensional gait analysis technology was used to collect the subjects' kinematic and dynamic parameters and gait deviation index (GDI) before and after the intervention， and to analyze the difference of efficacy between the two groups. Result： There was no significant difference in kinematics， dynamics and GDI between the two groups before treatment. Comparison between the two groups after treatment： Kinematic parameters： before and after intervention， maximum flexion angle of bilateral hip joint in the brace phase， maximum extension angle of bilateral hip joint， maximum flexion angle of right hip joint in the swing phase， maximum extension angle of right hip joint and maximum plantar flexion angle of right ankle in the experimental group had no obvious differences（P<0.05）. Dynamic parameters： Before and after intervention， the maximum plantar flexion moment of the left ankle in the supporting phase and the shock absorption capacity of the left ankle had significant differences（P<0.05）. After intervention， there were significant differences between the two groups： maximum plantar flexion moment of the right ankle in the support phase， maximum work of the right hip joint， maximum reaction force on the left side and shock absorption capacity of bilateral ankle joints（P<0.05）. Conclusion： Ballet training combined with conventional rehabilitation therapy can significantly improve the function of hip extension muscle， hip flexor muscle and foot flexor muscle in the children with spastic CP， and the efficacy is better than conventional rehabilitation training. This study provides a new idea for dance therapy of CP children in the future.