踝关节持续被动运动治疗脑瘫患儿腓肠肌痉挛疗效观察  

Curative effect of ankle joint continuous passive motion in treatment of gastrocnemius spasticity in children with cerebral palsy

作　　者：张利红[1] 袁俊英[1] 孙二亮[1] 张栋[1] ZHANG Li-hong YUAN Jun-ying SUN Er-liang ZHANG Dong(Department of Children＇ s Rehabilitation, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, Chin)

机构地区：[1]郑州大学第三附属医院儿童康复科,河南郑州450052

出　　处：《新乡医学院学报》2017年第4期290-293,共4页Journal of Xinxiang Medical University

摘　　要：目的探讨踝关节持续被动运动(CPM)治疗脑瘫患儿下肢腓肠肌痉挛的效果。方法将2015年2月至2016年2月在郑州大学第三附属医院儿童康复科治疗的11~36个月龄的腓肠肌痉挛脑瘫患儿70例分为观察组和对照组,每组35例。对照组患儿给予常规物理康复治疗,观察组患儿在对照组治疗基础上辅以踝关节CPM治疗。2组患儿治疗前及治疗6个月后分别采用改良Tardieu量表(MTS)评定腓肠肌痉挛程度、粗大运动功能测试量表(GMFM-88)评价粗大运动功能、表面肌电图(s EMG)评估腓肠肌肌张力,并对其进行比较。结果观察组和对照组患儿治疗前踝关节角度R2-R1差值、肌肉反应特性评分、GMFM-88评分及s EMG被动状态数值评分比较差异均无统计学意义(P>0.05)。治疗6个月后,观察组和对照组患儿踝关节角度R2-R1差值较治疗前显著缩小,且观察组患儿较对照组缩小更显著(P<0.05);观察组和对照组患儿肌肉反应特性评分较治疗前显著降低,且观察组患儿较对照组降低更显著(P<0.05);观察组和对照组患儿GMFM-88评分较治疗前显著升高,且观察组患儿较对照组升高更显著(P<0.05);观察组和对照组患儿s EMG被动状态评分较治疗前显著降低,且观察组患儿较对照组降低更显著(P<0.05)。结论踝关节CPM治疗配合常规物理康复训练治疗,对于改善11~36个月龄脑瘫患儿下肢腓肠肌痉挛有显著疗效,其效果优于单纯常规物理康复训练。Objective To observe the clinical efficacy of ankle joint continuous passive motion（ CPM） in treatment of gastrocnemius spasticity in children with cerebral palsy. Methods Seventy 11-36 months old children with cerebral palsy and gastrocnemius spasticity in Department of Children＇s Rehabilitation,the Third Affiliated Hospital of Zhengzhou University from February 2015 to February 2016 were selected and divided into observation group（ n = 35） and control group（ n = 35）.All patients were given conventional physical rehabilitation treatment; based on this,the patients in observation group were treated by ankle joint CPM. Before treatment and 6 months after treatment,the modified Tardieu scale（ MTS） was applied to assess the degree of gastrocnemius spasticity; the gross motor function measure 88（ GMFM-88） was used to evaluate the gross motor function; and the surface electromyography（ s EMG） were applied to evaluate the muscle tension of gastrocnemius muscle under the passive state. The results were compared between the two groups before and after treatment. Results There were no significant difference in the value of ankle joint angles R2-R1 and the scores of characteristics of muscle reaction,the GMFM scores,and the s EMG scores of patients between the two groups before treatment（ P〉0. 05）. After 6 months＇ treatment,the values of R2-R1 of patients in the two groups were significantly smaller than those before treatment（ P〈0. 05）; and the the values of R2-R1 of patients in the observation group were significantly smaller than those in the control group（ P〈0. 05）. After treatment,the scores of characteristics of muscle reaction of patients in the two groups were lower than those before treatment（ P〈0. 05）; the scores of characteristics of muscle reaction of patients in the observation group were significantly lower than those in the control group（ P〈0. 05）. After treatment,the GMFM-88 scores of patients in the two groups were significantly higher than before t

关 键 词：踝关节持续被动运动 儿童 脑瘫 腓肠肌痉挛 

分 类 号：R742.3[医药卫生—神经病学与精神病学]