揿针、手-臂双侧强化训练结合肌电生物反馈在痉挛型脑瘫患儿中的应用效果观察  

Observation on the application effect of screw needle,hand-arm bilateral intensive training combined with electromyography biofeedback in children with spastic cerebral palsy

作　　者：刘毅梅[1] 张娜[1] 何小辉[1] 唐巧萍[1] Liu Yimei;Zhang Na;He Xiaohui;Tang Qiaoping(The Affiliated Wuxi Children's Hospital of Nanjing Medical University,Wuxi,Jiangsu 214000,China)

机构地区：[1]南京医科大学附属无锡儿童医院,江苏无锡214000

出　　处：《首都食品与医药》2023年第17期152-156,共5页Capital Food Medicine

摘　　要：目的观察揿针、手-臂双侧强化训练结合肌电生物反馈在痉挛型脑瘫患儿中的应用效果.方法将90例痉挛型脑瘫患儿按照随机数字表法分为对照组和观察组,每组各45例.对照组患者给予常规作业治疗训练,在此基础上给予肌电生物反馈,观察组患者给予手-臂双侧强化训练,在此基础上给予揿针、肌电生物反馈治疗,4周为1个疗程,连续治疗2个疗程.对比两组患者的肢体痉挛程度改良Ashworth痉挛评定量表(MAS)评分、精细运动功能量表(FMFM)评分、粗大运动功能量表(GMFM)分、Berg平衡量表(BBS)评分、功能独立性评定量表(WeeFIM)评分变化.结果观察组的康复效果更好,有效率高达93.33%(42/45),显著高于对照组的75.56%(34/45),差异有统计学意义(χ^(2)=5.414,P<0.05);治疗4周、8周后,观察组的MAS评分均显著低于对照组(t=3.192,16.978,P<0.05),观察组的WeeFIM评分显著高于对照组(t=7.165,10.459,P<0.05);治疗8周后,观察组患者的精细运动功能、粗大运动功能、平衡能力改善优于对照组,FMFM、GMFM、BBS总分与对照组相比均显著升高(P<0.05).结论揿针、手-臂双侧强化训练结合肌电生物反馈可有效缓解痉挛型脑瘫患儿的肌痉挛程度,提高精细动作能力、粗大运动功能、平衡能力及功能独立性,值得临床推广.Objective To observe the application effect of screw needle,hand-arm bilateral intensive training combined with EMG biofeedback in children with spastic cerebral palsy.Methods 90 children with spastic cerebral palsy were divided into control group and observation group with 45 cases in each group according to random number table method.Patients in the control group were given routine operation therapy training,on the basis of which were given EMG biofeedback,and patients in the observation group were given hand-arm bilateral intensive training,on the basis of which were given screw needle and EMG biofeedback treatment,4 weeks as a course of treatment,for two courses of treatment.The changes of modified Ashworth Spasticity Rating Scale(MAS),Fine Motor Energy Scale(FMFM),Gross Motor Function Scale(GMFM),BergBalance Scale(BBS),and Functional Independence Rating Scale(WeeFIM)of limb spasticity in two groups were compared.Results The rehabilitation effect of the observation group was better,and the effective rate was as high as 93.33%(42/45),which was significantly higher than that of the control group 75.56%(34/45),the difference was statistically significant(χ^(2)=5.414,P<0.05).After 4 and 8 weeks of treatment,the MAS score of observation group was significantly lower than that of control group(t=3.192,16.978,P<0.05),and the WeeFIM score of observation group was significantly higher than that of control group(t=7.165,10.459,P<0.05).After 8 weeks of treatment,the improvement of fine motor function,gross motor function and balance ability in observation group was better than that in control group,and the total scores of FMFM,GMFM and BBS were significantly increased compared with control group(P<0.05).Conclusion The combination of press-needle,hand-arm bilateral intensive training and EMG biofeedback can effectively relieve the degree of muscle spasm in children with spastic cerebral palsy,and improve the fine motor ability,gross motor function,balance ability and functional independence,is worthy of clinical promoti

关 键 词：揿针 手-臂双侧强化训练 肌电生物反馈 痉挛型 脑瘫 

分 类 号：R742.3[医药卫生—神经病学与精神病学]