核心稳定性训练联合低能量体外冲击波治疗痉挛型脑瘫患儿的临床效果  

The effect of core stability training combined with low-energy extracorporeal shock wave therapy on children with spastic cerebral palsy

作　　者：李静梅 孙艳丽 郭晓迪 LI Jingmei;SUN Yani;GUO Xiaodi(Rehabilitation Department of Luoyang Third People's Hospital/First Affiliated Hospital of Luoyang Vocational and Technical College,Luoyang 471000,China)

机构地区：[1]洛阳市第三人民医院/洛阳职业技术学院第一附属医院康复科,河南洛阳471000

出　　处：《延安大学学报(医学科学版)》2025年第1期58-62,共5页Journal of Yan'an University:Medical Science Edition

摘　　要：目的分析核心稳定性训练联合低能量体外冲击波治疗痉挛型脑瘫患儿的效果。方法回顾性分析2020年3月至2023年3月洛阳市第三人民医院72例痉挛型脑瘫患儿资料,按不同康复治疗方案分为对照组与观察组,各36例。对照组采用低能量体外冲击波治疗,观察组采用核心稳定性训练+低能量体外冲击波治疗。比较两组肌张力[改良Ashworth量表(modified Ashworth scale,MAS)]、运动功能[粗大运动功能评估表-88(gross motor function measure-88,GMFM-88)]、平衡能力[Berg平衡量表(berg balance scale,BBS)]、表面肌电图[腓肠肌、内收肌的表面肌电信号均方根值(root mean square,RMS)、腓肠肌、内收肌的积分肌电值(integrated electromyography,iEMG)]、脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)、胰岛素样生长因子1(insulin-like growth factor 1,IGF-1)。结果治疗后观察组MAS评分低于对照组,BBS评分高于对照组(P<0.05);观察组D区、E区GMFM-88评分高于对照组(P<0.05);观察组内收肌iEMG、腓肠肌iEMG、IGF-1、BDNF高于对照组,内收肌RMS、腓肠肌RMS低于对照组(P<0.05)。结论核心稳定性训练联合低能量体外冲击波治疗痉挛型脑瘫可改善患儿肌张力,上调神经因子表达,促进运动功能与平衡能力恢复。Objective To analyze the effect of core stability training combined with low-energy extracorporeal shock wave therapy on children with spastic cerebral palsy.Methods The data of72 children with spastic cerebral palsy in the Third People's Hospital of Luoyang from March 2020 to March 2023 were retrospectively analyzed.According to different rehabilitation treatment plans,the patients were divided into the control group and the observation group,with 36 patients in each group.The control group was treated with low-energy extracorporeal shock wave therapy,while the observation group was treated with core stability training+low-energy extracorporeal shock wave therapy.The two groups were compared in terms of muscle tone(modified Ashworth scale,MAS),motor function(gross motor function measure-88,GMFM-88),balance ability(berg balance scale,BBS),surface electromyography(root mean square,RMS),integrated electromyography(iEMG),brain-derived neurotrophic factor(BDNF),and insulin-like growth factor 1(IGF-1)of the two groups were compared.Results Compared with control group,MAS score was lower and BBS score was higher in observation group after treatment(P<0.05).Compared with before treatment,GMFM-88 scores in D area and E area were significantly increased in observation group after treatment(P<0.05).Compared with before treatment,the adductor RMS and gastrocnemius RMS decreased in both groups,while the adductor iEMG and gastrocnemius iEMG increased in both groups,and the observation group was more significant(P<0.05).After treatment,IGF-1 and BDNF in observation group were higher than those in control group(P<0.05).Conclusion Core stability training combined with low-energy extracorporeal shock wave therapy can improve the muscle tone,up-regulate the expression of neurofactors,and promote the recovery of motor function and balance ability in children with spastic cerebral palsy.

关 键 词：痉挛型 脑瘫 核心肌群 肌张力 平衡能力 

分 类 号：R493[医药卫生—康复医学]