不同粗大运动功能脑性瘫痪患儿的日常生活活动能力分析  

Activities of daily living performance in children with cerebral palsy with different gross motor function

作　　者：史惟[1] 杨红[1] 黄华玉[1] 陈冬冬 

机构地区：[1]复旦大学附属儿科医院华泾社区卫生服务中心儿童康复中心,上海201102

出　　处：《中华物理医学与康复杂志》2009年第2期91-95,共5页Chinese Journal of Physical Medicine and Rehabilitation

摘　　要：目的分析不同程度粗大运动功能脑瘫患儿的日常生活活动能力表现，明确脑瘫患儿粗大运动功能与日常生活活动能力之间的关系。方法共有来自上海三家康复机构、年龄为18～90个月的脑瘫患儿118例参加此项研究。采用脑瘫粗大运动功能分级系统（GMFCS）进行粗大运动功能分级，用粗大运动功能测试量表（GMFM）进行粗大运动功能评估，用能力低下儿童评定量表（PEDI）进行日常生活活动能力评定，比较不同GMFCS级别间PEDI各项分值之间的差异，分析GMFCS和GMFM各项分值与PEDI分值之间的相关性。结果不同GMFCS级别间的PEDI分值表现出明显的差异性，PED!的分值大多会随着GMFCS级别的降低而增高，其中移动能力最为低下；PEDI尺度化分与GMFCS之间具有良好的相关性（rs=0．50～0．85，P〈0．001）；与GMFM各项分值之间也存在着不同程度的相关性（r=0．54～0．85，P〈0．001），其中移动能力与GMFCS和GMFM各项分值之间的相关性略高。结论不同粗大运动功能的脑瘫患儿日常生活活动能力存在明显差异。粗大运动功能越高、日常生活活动能力也越强。通过改善粗大运动功能可能可以改善脑瘫患儿的移动能力，同时还应该兼顾自理能力和社交能力的训练。Objective To analyze the activities of daily living （ADL） performance in children with cerebral palsy （CP） with different gross motor function and the correlation between gross motor function and ADL performance. Methods A total of 118 children （81 boys and 37 girls; mean age： 47.7 months, SD： 20.1 months, age range： 18 -90 months） with CP were recruited from three different rehabilitation centers in Shanghai. Types of CP included hemiplegia （ n = 27 ） , spastic diplegia （ n = 53 ） , spastic quadriplegia（ n = 29 ） , athetoid（ n = 4 ） , dystonic （ n = 4） , ataxic （ n = 1 ）. Gross motor function classification system （GMFCS） and Gross motor function measure （GMFM） were adopted to assess and classify the gross motor function. Pediatric evaluation of disability inventory （PEDI） was adopted to assess ADL performance. Differences of PEDI scores were compared among different levels of GMFCS; and the correlation between GMFCS levels, GMFM scores and PEDI scores were analyzed. Results PEDI scores showed significant differences among CP children with different levels of GMFCS. The PEDI score usually decreased with the increase of the GMFCS level, and mobility ability was the lowest. Significant correlations were found between PEDI scaled scores and GMFCS（ r = 0.85 - 0. 50, P 〈 0. 001 ）. Various levels of correlations （ r = 0.85 0.54, P 〈 0. 001 ） were found between GMFM scores and PEDI scaled scores. Higher correlations were found between GMFCS levels, GMFM scores and mobility ability. Conclusion ADL performance was significantly different among CP children with different gross motor function. The higher the gross motor function, the better the performance of ADL. Mobility would be improved by promoting gross motor function in CP children. The training of self-care and social communication ability should be emphasized.

关 键 词：脑性瘫痪 粗大运动功能 日常生活活动能力 

分 类 号：R742.3[医药卫生—神经病学与精神病学] R743.3[医药卫生—临床医学]