学龄期脑瘫青少年步行能力分析  

Analysis of walking ability of school aged children with cerebral palsy

作　　者：刘昊[1] 史惟[2] 周美琴 李惠娟[1] 杨红[2] 冉小华 

机构地区：[1]上海市浦东新区上钢社区卫生服务中心,上海200126 [2]复旦大学附属儿科医院康复中心,上海201102 [3]上海市浦东新区特殊教育学校,上海200135

出　　处：《中国儿童保健杂志》2016年第12期1296-1299,共4页Chinese Journal of Child Health Care

基　　金：国家自然科学基金项目(81273088)

摘　　要：目的明确学龄期脑瘫青少年的步行能力状况，为制定相应的康复干预策略提供依据。方法53名脑瘫学生纳入研究，其中男性36例，女性17例；平均年龄（12．2±2．7）岁，范围7．O～17．9岁；粗大运动功能分级（GMFCs）：I级15例，Ⅱ级38例。采用10m跑时间（10 m run test，10 mRT）和1min步行距离（1-minute walk test，1MWT）评价步行速度，6min步行距离（6-minute walk test，6MWT）评价步行耐力，物理消耗指数（physical cost index，PCI）评价步行能量消耗。所有纳入本研究的脑瘫学生均在至少3个月以后再次接受了上述测试。比较首次测试时GMFCSI级和Ⅱ级脑瘫学生各项测试结果之间的差异，同时分析脑瘫学生前后两次各项测试结果的差异。结果首次测试时GMFCSI级学生的步行速度明显快于GMFCSⅡ级学生（P〈O．01），步行耐力也好于GMFCSⅡ级学生（P〈0．001），两者PCI值差异无统计学意义；全部脑瘫学生在平均（4．8±1．3）个月后接受了第二次测试，前后两次测试各项测试结果间差异无统计学意义。结论学龄期脑瘫青少年中GMFCSI级青少年的步行速度、距离明显好于GMFCSⅡ级青少年，但是步行能量消耗无明显差异，短期间隔后各项步行能力测试指标均无明显改变。Objective To determine the waking ability of teenagers with cerebral palsy at school age. Methods Fif- ty-three students with cerebral palsy were selected including 36 males and 17 females. The average age were （12.2--4-2.7） years old with range from 7.0 to 17.9. Gross Motor Function Classification System （GMFCS） grade I had 15 cases and grade Ⅱ had 38 cases. 10 m run test （10 mRT） and 1-minute walk test （1MWT） were applied to evaluate the walking speed. 6-minute walk test （6MWT） was applied to assess the walking endurance and physical cost index （PCI） was applied to assess the walking energy consumption. All the students accepted retest after at least three months. The first test out- comes between GMFCS I and Ⅱ meanwhile and the difference between the first and the second test results were compared. Results In the first test,the walking speed of the students with GMFCS grade I was significantly faster than those with GMFCS grade Ⅱ （P〈0.01 ） and the walking endurance was also better in GMFCS grade I （P〈0.001）. There was no statis- tical difference for the PCI between them. All the students with cerebral palsy received the second test after （4.8 ± 1.3） months of average and there was no statistical difference of the results between the two tests. Conclusions Among the teenagers with cerebral palsy at school age,the walking speed and distance of students with GMFCS grade I are significant- ly better than those with GMFCS grade Ⅱ. However, there is no remarkable difference in walking energy consumption. After short-term interval, all the test parameters of walking ability stay the same.

关 键 词：脑瘫 步行能力 速度 耐力 能量消耗 

分 类 号：R179[医药卫生—妇幼卫生保健]