经颅直流电刺激结合改良强制性诱导训练对痉挛型偏瘫脑瘫患儿上肢功能的影响  

Effects of transcranial direct current stimulation combined with modified constraint-induced movement therapy on upper limb function in children with spastic hemiplegic cerebral palsy

作　　者：刘华[1] 郭春光[1] 段雅琴 周洪涛[1] 熊裕娟[1] 张玲[1] Liu Hua;Guo Chunguang;Duan Yaqin(Rehabilitation Centre of Hunan Children’s Hospital,Changsha 410007,China)

机构地区：[1]湖南省儿童医院康复中心,长沙410007

出　　处：《中国康复》2021年第6期339-343,共5页Chinese Journal of Rehabilitation

摘　　要：目的:探讨经颅直流电刺激(tDCS)结合改良强制性诱导训练(MCIMT)对痉挛型偏瘫脑瘫患儿上肢手功能的影响。方法:48例痉挛型偏瘫脑瘫患儿按照随机数字表法分成观察组25例和对照组23例,对照组予以常规康复治疗及MCIMT,观察组在此基础上加用tDCS治疗,2组患儿均在入院时及康复治疗8周后采用改良Ashworth肌张力评定量表(MAS)、Carroll上肢功能评定(UEFT)及改良Barthel指数(MBI)进行评定。结果:治疗8周后,2组患儿偏瘫侧MAS分级与治疗前比较差异均无统计学意义,且观察组较对照组比较差异也无统计学意义;2组患儿UEFT评分与治疗前比较均明显提高(均P<0.05),且观察组患儿的UEFT评分更高于对照组(P<0.05);2组3岁以上患儿MBI评分与治疗前比较均明显提高(均P<0.05),且观察组3岁以上患儿MBI评分更高于对照组(P<0.05)。结论:tDCS结合MCIMT能改善痉挛型偏瘫型脑瘫患儿的上肢手功能及日常生活能力,值得临床进一步推广。Objective:To investigate the impact of transcranial direct current stimulation(tDCS)combined with modified constraint-induced movement therapy(MCIMT)on upper limb function in children with spastic hemiplegic cerebral palsy.Methods:A total of 48 children with spastic hemiplegic cerebral palsy were randomly divided into treatment group(n=25)and control group(n=23)by the random number table.The control group and treatment group received routine rehabilitation and MCIMT,and the treatment group received tDCS therapy in addition.Before and after 8 weeks of treatment,the muscle tension of upper limb was measured using modified Ashworth scale(MAS),the upper limb function was measured using Carroll upper extremities functional test(UEFT),and daily life ability was measured using modified Barthel index(MBI).Results:After 8 weeks of treatment,there was no significant difference in MAS classification of hemiplegic side in the two groups,and there was no significant difference between the treatment group and the control group.The UEFT scores in the two groups after 8 weeks of treatment were significantly higher than those before treatment(all P<0.05),and the UEFT scores in the treatment group were higher than those in the control group(P<0.05).The MBI scores in children over 3 years old in both groups were significantly higher than those before treatment(all P<0.05),and the MBI scores of children over 3 years old in the treatment group were higher than those in the control group(P<0.05).Conclusion:The tDCS combined with MCIMT can improve upper limb function and daily life ability in children with spastic hemiplegic cerebral palsy and it is worthy of promotion in clinic.

关 键 词：经颅直流电刺激 改良强制性诱导训练 痉挛型偏瘫 上肢功能 日常生活能力 

分 类 号：R49[医药卫生—康复医学] R742.3[医药卫生—临床医学]