经腰椎旁区的神经肌肉电刺激对痉挛型脑瘫患儿运动功能的影响  

Effect of neuromuscular electrical stimulation of lumbar paraspinal regions on motor function of children with spastic cerebral palsy

作　　者：唐巧萍[1] 何小辉[1] 张娜[1] Tang Qiaoping;He Xiaohui;Zhang Na(Department of Rehabilitation Medicine,Wuxi Children’s Hospital Affiliated to Nanjing Medical University,Wuxi 214023,China)

机构地区：[1]南京医科大学附属无锡儿童医院康复医学科,江苏无锡214023

出　　处：《中国康复》2022年第11期652-655,共4页Chinese Journal of Rehabilitation

基　　金：无锡市卫健委无锡市“双百”中青年医疗卫生后备拔尖人才项目(HB2020085)。

摘　　要：目的:分析经腰椎旁区的神经肌肉电刺激(NMES)对痉挛型脑瘫患儿运动功能的影响。方法:将痉挛型脑瘫患儿60例随机分为观察组和对照组各30例,2组均采用常规运动疗法,观察组在实施常规运动疗法中的核心稳定性训练时,辅以经腰椎旁区的NMES激活脊柱深部稳定肌。治疗前及治疗4、8、12周后分别记录患儿粗大运动功能量表(GMFM)评分、Berg平衡量表(BBS)评分、步行速度、生理耗能指数(PCI)。结果:治疗前,2组GMFM评分、BBS评分、步行速度以及PCI均无统计学差异,治疗4周后,2组患儿上述指标与治疗前及组间比较差异无统计学意义;治疗8周后的观察组患儿及治疗12周后的2组患儿上述各项指标较治疗前均有明显改善(均P<0.05),且观察组均优于对照组(均P<0.05)。2组患儿GMFM评分、BBS评分、步行速度以及PCI的时间效应、组间效应和交互作用的差异均具有统计学意义(均P<0.05)。结论:经腰椎旁区的NMES可明显改善痉挛型脑瘫患儿粗大运动功能和平衡功能,提高步行速度,并有效降低步行能量消耗,疗效优于单纯常规运动疗法。Objective:To analyze the effect of neuromuscular electrical stimulation(NMES)of lumbar paraspinal regions on motor function of children with spastic cerebral palsy.Methods:A total of 60 children with spastic cerebral palsy meeting the inclusion criteria were selected,and randomly divided into a control group and a observation group(n=30 each).Both groups were given standard physical therapy that included core stability training.The observation group was subjected to NMES of lumbar paraspinal regions additionally.Before enrollment and after 4 weeks,8 weeks,and 12 weeks of the group treatment,the children were evaluated by Gross Motor Function Scale(GMFM)score,Berg Balance Scale(BBS)score,walking speed,and Physiological Cost Index(PCI).Results:Before treatment,the two groups had no significant difference in GMFM score,BBS score,walking speed and PCI.After 8 weeks of treatment in the observation group and 12 weeks after treatment in the two groups,the above indicators in both groups were significantly improved as compared with those before treatment(P<0.05).After 8 weeks of treatment,the observation group was significantly better than the control group(P<0.05).The time effect,intra-group effect and interaction of GMFM score,BBS score,walking speed and PCI between the two groups were statistically significant(P<0.05).Conclusion:NMES of lumbar paraspinal regions can significantly improve the gross motor function and balance function of children with spastic cerebral palsy,increase walking speed,and effectively reduce walking energy consumption.The effect is better than simple standard physical therapy.

关 键 词：脑瘫 神经肌肉电刺激 脊柱深部稳定肌 核心稳定性训练 运动功能 

分 类 号：R49[医药卫生—康复医学] R742[医药卫生—临床医学]