呼吸训练对痉挛型四肢瘫患儿步行耐力及平衡能力的疗效观察  

Observation on the effect of respiratory training on walking endurance and balance ability of children with spastic quadriplegia

作　　者：岳青[1] 张通[3] 胡晓诗 李思佳 冯啊美 周天添 杨冰兵 郭荣荣 Yue Qing;Zhang Tong;Hu Xiaoshi;Li Sijia;Feng Amei;Zhou Tiantian;Yang Bingbing;Guo Rongrong(School of Rehabilitation Medicine,Capital Medical University,Beijing 100068,China)

机构地区：[1]首都医科大学康复医学院,北京100068 [2]中国康复研究中心北京博爱医院儿童物理疗法科 [3]中国康复研究中心北京博爱医院神经康复科

出　　处：《北京医学》2024年第5期395-400,共6页Beijing Medical Journal

摘　　要：目的探讨呼吸训练对痉挛型四肢瘫(spastic quadriplegia,SP)患儿步行耐力及平衡能力的影响。方法选取2021年11月至2023年11月中国康复研究中心北京博爱医院SP患儿60例,随机分为对照组(n=30)与试验组(n=30)。对照组接受常规康复训练(60 min/次),试验组接受常规康复训练(40 min/次)和呼吸训练(20 min/次);两组训练频率为1次/d,5 d/周,连续4周。分别采用10米步行测试(10-meter work test,10MWT)速度、6分钟步行测试(6-minute walk test,6MWT)距离、Berg平衡量表(Berg balance scale,BBS)评分和肺活量(vital capacity,VC)、用力肺活量(forced vital capacity,FVC)、1秒用力呼气量(forced expiratory volume in first second,FEV1)、呼气峰值流速(peak expiratory flow,PEF)评估患儿训练前后步行耐力、平衡能力和肺功能。结果60例患儿中,男31例、女29例,年龄6~12岁,平均(9.0±1.7)岁。两组性别、年龄、粗大运动功能分级系统(gross motor function classification system,GMFCS)的比较,差异均无统计学意义(P>0.05)。训练4周后,两组患儿的6MWT距离、BBS评分、10MWT速度、FVC、FEV1、PEF均高于训练前,且试验组均高于对照组,差异有统计学意义(P<0.05)。结论呼吸训练能有效改善SP患儿的步行耐力、平衡能力,提高肺功能,增强有氧运动的耐力,降低跌倒风险,提高日常生活质量。Objective To explore the effect of breathing training on walking endurance and balance ability of children with spastic quadriplegia(SP).Methods A total of sixty SP children from Beijing Boai Hospital of China Rehabilitation Research Center from November 2021 to November 2023 were selected,and were randomly divided into control group(n=30)and experimental group(n=30).The control group received routine rehabilitation training for 60 min each time;while the experimental group received routine rehabilitation training for 40 min each time and breathing training for 20 min each time.Both groups received trainging for once a day,five days a week for four consecutive weeks.The 10-meter work test(10MWT)speed,6-minute walk test(6MWT)distance,Berg balance scale(BBS)score and vital capacity(VC),forced vital capacity(FVC),forced expiratory volume in first second(FEV1),and peak expiratory flow(PEF)were used to assess and compare the walking endurance,balance ability and lung function before and after training.Results Among the 60 patients,there were 31 males and 29 females,aged from 6 to 12 years,with an average age of(9.0±1.7)years.There were no significant differences in gender,age and gross motor function classification system(GMFCS)results between the two groups(P>0.05).After four weeks of training,the 6MWT distance,BBS score,10MWT speed,FVC,FEV1 and PEF of the two groups of were higher than those before training,and the experimental group were higher than those of the control group,with statistical significance(P<0.05).Conclusions Breathing training can effectively improve the walking endurance,balance ability,lung function,endurance of aerobic exercise,reduce the risk of falling and improve the quality of daily life of children with SP.

关 键 词：呼吸训练 痉挛型四肢瘫 步行耐力 平衡能力 儿童 

分 类 号：R742.3[医药卫生—神经病学与精神病学]