运动康复和适应性身体活动对痉挛性脑性瘫痪儿童青少年心理运动功能、运动功能和动作发展的效益:基于ICF的循证研究  

Effect of exercise rehabilitation and adapted physical activity on psychomotor skills,motor abilities and motor development in children and adolescents with spastic cerebral palsy:an evidence-based research using ICF

作　　者：吴亮 许秀 罗亮 WU Liang;XU Xiu;LUO Liang(Shaanxi Rehabilitation Hospital,Xi'an,Shannxi 710065,China)

机构地区：[1]陕西省康复医院,陕西西安市710065

出　　处：《中国康复理论与实践》2024年第2期148-156,共9页Chinese Journal of Rehabilitation Theory and Practice

基　　金：陕西省重点研发计划(No.2024SF-YBXM-314)。

摘　　要：目的 系统评价运动康复和适应性身体活动对痉挛性脑瘫儿童心理运动功能、运动功能和动作发展影响的相关证据。方法 在PubMed、Embase、Web of Science和中国知网检索相关文献,时间范围为2010年1月至2023年6月。基于《国际疾病分类第十一次修订本》和《国际功能、残疾和健康分类》对文献内容进行解析和编码,并进行循证证据研究。结果 共纳入9篇文献,来自丹麦、韩国、澳大利亚、沙特阿拉伯、加纳、印度、日本,发表时间2015年至2022年。干预类型主要涉及运动康复(包括物理治疗)和适应性身体活动。运动康复包括上肢力量训练、下肢力量训练、平衡和协调训练、步态训练、功能性有氧运动、伸展和柔韧性练习、灵活性训练、肌肉放松技术;每次10~50 min,每周2~6次,身体活动强度为低~高,持续6~20周。适应性身体活动主要涉及适应性跑步训练、虚拟游戏;每次60 min,每周2~4次,身体活动强度为中至高强度,持续6~12周。干预场所主要为医疗和康复机构、学校、家庭社区。干预人员主要包括职业物理治疗师、大学研究人员、社区卫生人员和教师。干预结局主要体现在4个方面:心理运动功能、运动功能、动作发展、生活质量与福祉。在心理运动功能方面,脑瘫儿童青少年掌握跑步功能和知识,增强平衡反应能力。在运动功能方面,脑瘫儿童青少年肌力增加,肌肉耐力增强,肌张力扩大;步态功能、步行功能、步态对称性改善;行走耐力提高;站立功能改善;动态平衡改善;平衡控制能力改善。在动作发展方面,日常生活活动能力提高,学校以及闲暇时间休闲活动参与水平提高,运动范围扩大。在生活质量与福祉方面,脑瘫儿童青少年自信心和自尊心增强,疼痛缓解,社会幸福感和接受度提升。结论 本研究系统评价运动康复和适应性身体活动对痉挛性脑瘫儿童和青少年心理运�Objective To systematically review the evidences of impact of exercise rehabilitation and adapted physical activity on psychomotor skills,motor abilities,and motor development in children with spastic cerebral palsy(CP).Methods Relevant literature was retrieved from PubMed,Embase,Web of Science and CNKI,from January,2010 to June,2023.The contents were coded using International Classification of Diseases,Eleventh Revision,and International Classification of Functioning,Disability and Health;and evidences were analyzed with theoretical framework and code of ICD-11 and ICF.Results A total of nine articles were included,from Denmark,South Korea,Australia,Saudi Arabia,Ghana,India and Japan,published from 2015 to 2022.The intervention programs primarily involved exercise rehabilitation(including physical therapy)and adapted physical activity.Exercise rehabilitation included upper limb strength training,lower limb strength training,balance and coordination training,gait training,functional aerobic exercise,stretching and flexibility exercises,flexibility training,muscle relaxation techniques;ten to 50 minutes a time,two to six times a week,with the intensity of low to high,for six to 20 weeks.Adapted physical activities mainly involved adapted running training,virtual games;60 minutes a time,two to four times a week,with the intensity of medium to high,for six to twelve weeks.Interventions primarily took place in medical and rehabilitation institutions,schools,and home-based communities,with professionals including occupational physical therapists,university researchers,community health personnel and teachers.The outcomes were mainly reflected in four aspects:psychomotor skills,motor abilities,motor development,and quality of life and well-being.In terms of psychomotor skills,adolescents with CP mastered running techniques and knowledge,and enhanced their response to balance threats.In terms of motor abilities,adolescents with CP showed an increase in muscle strength,enhanced muscle endurance,and an expansion of muscle

关 键 词：痉挛性脑性瘫痪 运动康复 适应性身体活动 心理运动功能 运动功能 动作发展 

分 类 号：R742.3[医药卫生—神经病学与精神病学]