居家弹力带抗阻训练对严重烧伤患儿肌肉功能和步行能力影响的前瞻性研究  

Prospective study on the effects of resistance training with elastic band at home on muscle function and walking ability of severely burned children

作　　者：霍婷 阮晶晶 蒋梅君 雷芳 黄伟[2] 汤文倩 谢卫国 徐向阳 王松[3] 刘淑华 Huo Ting;Ruan Jingjing;Jiang Meijun;Lei Fang;Huang Wei;Tang Wenqian;Xie Weiguo;Xu Xiangyang;Wang Song;Liu Shuhua(Department of Burns,Tongren Hospital of Wuhan University&Wuhan Third Hospital,Wuhan 430060,China;Department of Radiology,Liyuan Hospital of Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430077,China;College of Sports Medicine,Wuhan Sports University,Wuhan 430079,China)

机构地区：[1]武汉大学同仁医院暨武汉市第三医院烧伤科,武汉430060 [2]华中科技大学同济医学院附属梨园医院放射科,武汉430077 [3]武汉体育学院运动医学院,武汉430079

出　　处：《中华烧伤与创面修复杂志》2023年第12期1131-1139,共9页Chinese Journal of Burns And Wounds

基　　金：国家重点研发计划(2019YFE0196800);武汉市科技局知识创新专项(2023020201010190)。

摘　　要：目的探讨居家弹力带抗阻训练对严重烧伤患儿的肌肉功能和步行能力的作用。方法采用前瞻性非随机对照研究方法。2022年1月—2023年4月,武汉大学同仁医院暨武汉市第三医院收治40例符合入选标准的严重烧伤患儿,根据患儿或其家属意愿将患儿分为常规康复组和联合康复组,研究过程中脱落8例,最终常规康复组纳入17例患儿[男6例、女11例,年龄(8.5±2.4)岁],联合康复组纳入15例患儿[男5例、女10例,年龄(9.6±2.5)岁]。2组患儿在院内均接受常规烧伤康复治疗,包括主、被动活动训练和瘢痕按摩及压力治疗等。联合康复组患儿在出院后行每周3~5次的弹力带抗阻训练,常规康复组患儿出院后进行日常活动能力训练。在居家康复训练前(出院前1周)和居家康复训练12周后,采用手持握力仪测量握力,采用便携式肌力测量仪测量上肢和下肢肌力,采用生物电阻抗测量仪测量瘦体重,测量6 min步行距离。对数据行独立样本t检验、配对样本t检验、Mann-Whitney U检验、Fisher确切概率法检验。结果居家康复训练12周后,联合康复组和常规康复组患儿握力分别为(15±4)、(11±4)kg,明显大于居家康复训练前的(10±4)、(9±4)kg(t值分别为-9.99、-11.89,P值均<0.05);联合康复组患儿的握力明显大于常规康复组(t=3.24,P<0.05)。居家康复训练12周后,联合康复组患儿上肢和下肢肌力(t值分别为-11.39、-3.40,P<0.05)、常规康复组患儿上肢和下肢肌力(t值分别为-7.59、-6.69,P<0.05)均明显大于居家康复训练前,联合康复组患儿上肢和下肢肌力均明显大于常规康复组(t值分别为3.80、7.87,P<0.05)。居家康复训练12周后,联合康复组患儿瘦体重明显大于居家康复训练前(t=0.21,P<0.05)。居家康复训练12周后,常规康复组和联合康复组患儿6 min步行距离均明显长于居家康复训练前(t值分别为-5.33、-3.40,P<0.05),联合康复组患儿6 min步行距离明�Objective To explore the effects of resistance training with elastic band at home on muscle function and walking ability of severely burned children.Methods A prospective non-randomized controlled study was conducted.From January 2022 to April 2023,40 children with severe burns who met the inclusion criteria were admitted to Tongren Hospital of Wuhan University&Wuhan Third Hospital.According to the willingness of the children or their families,the children were assigned to conventional rehabilitation group and combined rehabilitation group.During the study,8 children dropped out of the study,17 children were finally included in the conventional rehabilitation group with 6 males and 11 females,aged(8.5±2.4)years,and 15 children were included in the combined rehabilitation group with 5 males and 10 females,aged(9.6±2.5)years.The children in the 2 groups received conventional burn rehabilitation treatment in the hospital,including active and passive activity training,scar massage,and pressure therapy.The children in combined rehabilitation group received resistance training with elastic band of 3 to 5 times per week after discharge,and the children in conventional rehabilitation group received daily activity ability training after discharge.Before home rehabilitation training(1 week before discharge)and 12 weeks after home rehabilitation training,the grip strength was measured using a handheld grip dynamometer,the muscle strengths of the upper and lower limbs were measured using a portable dynamometer for muscle strength,lean body mass was measured by bioelectrical impedance measuring instrument,and the 6-min walking distance was measured.Data were statistically analyzed with independent sample t test,paired sample t test,Mann-Whitney U test,or Fisher's exact probability test.Results After 12 weeks of home rehabilitation training,the grip strengths of children in combined rehabilitation group and conventional rehabilitation group were(15±4)and(11±4)kg,respectively,which were significantly higher than(10±4)and(9

关 键 词：烧伤 儿童 康复 弹力带 肌肉功能 步行能力 

分 类 号：R726[医药卫生—儿科]