粗大运动功能测试量表与Gesell发育量表在脑性瘫痪疗效评估中的应用比较  

Comparison of the gross motor function measure and Gesell’s gross motor developmental schedule in the assessment of rehabilitation effect on children with cerebral palsy

作　　者：于华凤[1] 李洪英[1] 马海霞[1] 

机构地区：[1]山东大学齐鲁儿童医院,山东省济南市250022

出　　处：《中国组织工程研究与临床康复》2007年第30期5925-5927,5934,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：目的:比较粗大运动功能测试量表及Gesell发育量表在脑性瘫痪康复疗效评估中的应用效果。方法:选择2005-05/12在山东大学齐鲁儿童医院康复中心初次接受康复治疗的脑性瘫痪患儿25例,符合2004年全国小儿脑性瘫痪研讨会制定的诊断标准(金标准),监护人均知情同意。脑性瘫痪患儿均采用综合康复治疗:①Vojet法。②Bobath法。③推拿。④针灸,每次留针1h。每周连续治疗6d,休息1d,持续治疗3个月为1个疗程。所有患儿在接受康复治疗前及治疗1个疗程后均进行粗大运动功能测试量表和Gesell发育量表粗大运动发育龄、发育商评估。①粗大运动功能测试量表:总分100分表明患儿能完全完成该量表的全部内容,0分表明患儿不能完成该量表的最低运动评估项目。总分百分比为5个能区原始分占各自总分百分比之和再除以5。②Gesell发育量表:发育龄=∑(M×n)÷∑n(M代表测查取的月龄,n代表测查通过的项目,∑为若干数据的总和);发育商为测得的发育年龄与实际年龄的百分比。大运动发育商数55～75为轻度障碍,40～54为中度障碍,25～39为重度障碍,<25为极重度障碍。结果:25例患儿全部进入结果分析,无脱落。①治疗前及治疗1个疗程后患儿的量表评分比较:康复治疗进行1个疗程后患儿的粗大运动功能测试量表总分百分比及Gesell粗大运动发育龄显著高于治疗前[(22.64±4.18)%,(11.92±3.42)个月;(16.96±4.50)%,(10.18±3.48)个月(t=28.74,16.44,P<0.01)],而发育商显著低于治疗前(50.05±8.04,51.12±8.20,t=11.85,P<0.01)。②两个量表的敏感性比较:粗大运动功能测试量表总分百分比治疗后提高百分比为(6.46±5.65)%,Gesell发育量表粗大运动发育龄治疗后提高百分比为(1.28±1.29)%,两者之间差异具有显著性意义(P<0.01)。结论:Gesell发育量表在脑性瘫痪康复疗效评估中有一定的局限性,粗大运动功能测试量表可用于脑性瘫痪康�AIM： To compare the effect of the gross motor function measure （GMFM） and Gesell＇s developmental schedule （GDS） in assessment of rehabilitation effectiveness in children with cerebral palsy. METHODS： Twenty-five children with cerebral palsy, who were firstly treated in the Rehabilitation Center of Qilu Children＇s Hospital Affiliated to Shandong University from May to December 2005 were selected, and all patients met the diagnostic criteria designed by the State Seminar On Children With Cerebral Palsy in 2004, and the guardians of patients knew and agreed with the items. All enrolled subjects received combined rehabilitation therapy： （1） Vojet method. （2） Bobath method. （3） Tuina. （4） Acupuncture and moxibustion. The needle was remained for one hour each time, and the treatment was performed for 6 successive days with an interval of one day for totally 3 months. All patients were evaluated by GMFM and GDS on gross motor developmental age and developmental quotient （DQ）. （1） The percentage of the total score equaled to the total percentage of the primary scores of each region by divided into 5. （2） GDS： The developmental age = ∑ （M×n）÷∑n （M stands for the detected month, and n stands for the detected item, while ∑ stands for the sum of data）. The DQ was the percentage of developmental age and real age. Children with the DQ ranged 55-75 was slight disturbance, 40-54 as middle disturbance, 25-39 as severe disturbance, and those below 25 were considered as severer disturbance. RESULTS： A total of 25 patients were involved in the analysis, and no one withdrew from the study. （1） Comparison in score before the treatment and that at one course after the treatment： The total percentage of the total scores in GMFM and GDS after one course after the treatment were significantly higher than those before the treatment [（22.64±4.18）%, （ 11.92±3.42 ） months; （ 16.96±4.50 ）%, （10.18±3.48） months, （ t =28.74, 16.44,P 〈 0.01 ）], while

关 键 词：脑性瘫痪 运动疗法 功能恢复 

分 类 号：R742.3[医药卫生—神经病学与精神病学]