悬吊运动训练对脑性瘫痪患儿下肢运动功能影响的meta分析  

Meta-analysis of the effect of sling exercise training on lower limbs motor function of children with cerebral palsy

作　　者：苏鹏 李永杰 胡时静 孟思进[3] SU Peng;LI Yongjie;HU Shijing;MENG Sijin(Graduate School,Wuhan Sports University,Hubei Province,Wuhan 430079,China;School of Health,Wuhan University,Hubei Province,Wuhan 430071,China;College of Health Science,Wuhan Sports University Hubei Key Laboratory of Sport Training and Monitoring,Hubei Province,Wuhan 430079,China)

机构地区：[1]武汉体育学院研究生院,湖北武汉430079 [2]武汉大学健康学院,湖北武汉430071 [3]武汉体育学院健康科学学院运动训练监控湖北省重点实验室,湖北武汉430079

出　　处：《中国医药导报》2021年第30期105-109,113,共6页China Medical Herald

基　　金：国家社会科学基金项目(19BTY046)。

摘　　要：目的系统评价悬吊运动训练(SET)对脑性瘫痪(CP)患儿下肢运动功能的影响。方法计算机检索中国知网、万方数据、维普、CBM、PubMed、EMbase、The Cochrane Library、Web of Science、Science Direct数据库中有关SET治疗CP患儿的临床随机对照试验,检索时间自建库至2020年8月。由两名研究者依据纳入与排除标准对文献进行筛选,对所纳入文献进行数据提取和质量评价。采用RevaMan 5.1软件对所提取的数据进行分析。结果共纳入18篇文献,1499例患者。试验组粗大运动功能评定量表(GMFM)-D区得分高于对照组,差异有统计学意义(WMD=4.36,95%CI:3.06,5.67,P<0.00001)。试验组GMFM-E区得分高于对照组,差异有统计学意义(WMD=5.89,95%CI:4.33,7.45,P<0.00001)。试验组最大步行速度高于对照组,差异有统计学意义(WMD=3.04,95%CI:2.29,3.80,P<0.00001)。试验组内收肌表面肌电信号均方根(RMS)值低于对照组,差异有统计学意义(WMD=-2.23,95%CI:-3.24,-1.22,P<0.0001)。试验组腓肠肌表面肌电信号RMS值低于对照组,差异有统计学意义(WMD=-2.42,95%CI:-3.36,-1.48,P<0.00001)。结论SET可有效改善CP患儿的下肢运动功能,提高步行速度,降低下肢肌张力,但仍需高质量、大样本随机对照研究进一步论证。Objective To systematically evaluate the effect of sling exercise training(SET) on lower limbs motor function in children with cerebral palsy(CP).Methods Clinical randomized controlled trials of SET in the treatment of children with CP were searched in CNKI,Wanfang Data,VIP,CBM,PubMed,EMbase,The Cochrane Library,Web of Science,and Science Direct databases,retrieval time was self-built database to August 2020.Two researchers screened the literature according to inclusion and exclusion criteria,extracted data and evaluated the quality of the included literature.RevMan 5.1 software was used to analyze the extracted data.Results A total of 18 articles and 1499 patients were included.The score of gross motor function measure scale(GMFM)-D area in the experimental group were higher than those in the control group,and the difference was statistically significant(WMD = 4.36,95%CI:3.06,5.67,P < 0.00001).The score of GMFM-E area in the experimental group was higher than that in the control group,and the difference was statistically significant(WMD = 5.89,95%CI:4.33,7.45,P < 0.000 01).The maximum walking speed in the experimental group was higher than that in the control group,and the difference was statistically significant(WMD =3.04,95%CI:2.29,3.80,P < 0.000 01).The root mean square(RMS) value of adductor surface electromyogram signal in the experimental group was lower than that in the control group,and the difference was statistically significant(WMD =-2.23,95%CI:-3.24,-1.22,P < 0.0001).The RMS value of gastrocnemius surface electromyogram signal in the experimental group was lower than that in the control group,and the difference was statistically significant(WMD =-2.42,95%CI:-3.36,-1.48,P < 0.000 01).Conclusion SET can effectively improve lower limbs motor function,improve walking speed and reduce lower limbs muscle tension in CP children,but high-quality,large-sample randomized controlled studies are still needed for further demonstration.

关 键 词：悬吊运动训练 脑性瘫痪 下肢 META分析 

分 类 号：R742.3[医药卫生—神经病学与精神病学]