经颅直流电刺激联合目标导向性训练对脑性瘫痪儿童精细及粗大运动功能的影响  

Effects of transcranial direct current stimulation combined with goal-oriented training on fine and gross motor function in children with cerebral palsy

作　　者：贾佳 刘彬 张建奎[3] Jia Jia;Liu Bin;Zhang Jian-kui(Department of Child Rehabilitation,Luoyang Bonesetting Hospital,Luoyang 471000,Henan,China;Department of Child Rehabilitation,Luoyang Maternal and Child Health Hospital,Luoyang 471000,Henan,China;Department of Pediatrics,The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000,China)

机构地区：[1]河南省洛阳正骨医院儿童康复科,河南洛阳471000 [2]河南省洛阳市妇幼保健院儿童康复科,河南洛阳471000 [3]河南中医药大学第一附属医院儿科,河南郑州450000

出　　处：《四川生理科学杂志》2025年第1期4-7,43,共5页

基　　金：2022年度河南省医学科技攻关计划联合共建项目(编号:LHGJ20220619)。

摘　　要：目的:探讨经颅直流电刺激联合目标导向性训练对脑性瘫痪儿童精细及粗大运动功能的影响。方法:选取2022年2月-2024年2月医院收治的痉挛型脑性瘫痪儿童84例,采用随机数字表法将其分为观察组和对照组。入组后对照组给予目标导向性训练,观察组在此基础上接受经颅直流电刺激治疗,共治疗3 m。分别采用精细运动功能量表(FMFM)、粗大运动功能量表88项(GMFM-88)、改良Ashworh量表(mAS)评估患儿精细和粗大运动功能及肌张力。结果:观察组治疗总有效率显著高于对照组(P<0.05)。与治疗前比较,治疗3 m后两组患儿视觉追踪、上肢活动、抓握、操作、手眼协调各项能力评分及FMFM总分均显著升高,且观察组高于对照组(P<0.05)。与治疗前比较,治疗3 m后两组患儿卧位与翻身、坐位、爬与跪、站立位、行走与跑跳功能区评分及GMFM-88总分均显著升高,且观察组高于对照组(P<0.05)。与治疗前比较,治疗3 m后两组患儿上肢和下肢mAS评分均显著降低,且观察组低于对照组(P<0.05)。结论:经颅直流电刺激联合目标导向性训练可显著改善痉挛型脑性瘫痪儿童精细和粗大运动功能,降低肌张力,其效果优于单纯的目标导向性训练,具有临床推广价值。Objective:To explore the effects of transcranial direct current stimulation combined with goal-oriented training on fine and gross motor function in children with cerebral palsy.Methods:A total of 84 children with spastic cerebral palsy admitted to hospital from February 2022 to February 2024 were selected and divided into observation group and control group by random number table method.After admission,the control group was given target-oriented training,and the observation group received transcranial direct current stimulation therapy on this basis for a total of 3 months.Fine motor function measure scale(FMFM),gross motor function measure-88(GMFM-88)and modified ashworth scale(mAS)were used to evaluate fine and gross motor function and muscle tone.Results:The total effective rate of observation group was significantly higher than that of control group(P<0.05).Compared with before treatment,visual tracking,upper limb movement,grasping,manipulation,hand-eye coordination scores and FMFM total scores in 2 groups were significantly increased after 3 months of treatment,and the observation group was higher than the control group(P<0.05).Compared with before treatment,after 3 months of treatment,the functional scores of lying position and turning over,sitting position,crawling and kneeling position,standing position,walking and running jump and GMFM-88 total scores of the two groups were significantly increased,and the observation group was higher than the control group(P<0.05).Compared with before treatment,mAS scores of upper and lower limbs were significantly decreased in both groups after 3 months of treatment,and the observation group was lower than the control group(P<0.05).Conclusion:Transcranial direct current stimulation combined with goal-oriented training can significantly improve fine and gross motor functions and reduce muscle tension in children with spastic cerebral palsy.The effect is better than that of simple goal-oriented training,which has clinical value.

关 键 词：痉挛型脑性瘫痪 经颅直流电刺激 目标导向性训练 精细运动 粗大运动 肌张力 

分 类 号：R47[医药卫生—护理学]