基于游戏的整合性神经肌肉训练联合常规康复治疗对痉挛性偏瘫儿童的影响  

Effects of Game-Based Integrative Neuromuscular Training Combined with Conventional Rehabilitation on Children with Spastic Hemiplegia

作　　者：卢文清 武志华[1] 高婧慧 刘文近 黄艳[1] LU Wenqing;WU Zhihua;GAO Jinghui;LIU Wenjin;HUANG Yan(Children's Hospital Affiliated to Shandong University,Jinan,Shandong 250022,China;Yantai Gold College,Yantai,Shandong 265401,China)

机构地区：[1]山东大学附属儿童医院,山东济南250022 [2]烟台黄金职业学院,山东烟台265401

出　　处：《康复学报》2025年第2期138-145,共8页Rehabilitation Medicine

基　　金：济南市卫生健康委员会科技计划项目(2023-2-133);山东省儿童健康与疾病临床医学研究中心项目(RC011);济南市医疗卫生行业高层次人才专项(202412)。

摘　　要：目的观察基于游戏的整合性神经肌肉训练(INT)联合常规康复治疗对痉挛性偏瘫(SH)儿童的影响。方法选择2023年1—6月在山东大学附属儿童医院康复科接受治疗的SH儿童40例,采用随机数字表法分为对照组和试验组,每组20例。其中对照组因提前出院脱落3例,试验组因注射肉毒素脱落1例、提前出院脱落2例,2组最终各纳入17例。对照组接受常规康复治疗(作业疗法、蜡疗和低频脉冲电刺激)和常规运动疗法训练(肌力训练、关节活动度训练、平衡训练和步态训练),每个项目训练20 min/次,1次/d,5次/周,持续治疗12周。试验组在对照组常规康复治疗基础上接受基于游戏的整合性神经肌肉训练,包括力量训练、速度灵敏训练、动态稳定性训练、快速伸缩复合训练、核心稳定性训练,20 min/次,1次/d,5次/周,持续治疗12周。治疗前后分别采用BioNeuro生物反馈仪和Flexcomp Infiniti System表面肌电分析系统测量分析患侧被动牵伸状态下股四头肌、腘绳肌、腓肠肌和内收肌的均方根值(RMS);采用Microfet2手持肌力测试仪测量患侧髋屈肌、髋伸肌、膝伸肌、膝屈肌、踝背屈肌和踝跖屈肌的肌力;采用粗大运动功能量表88项(GMFM-88)D区和E区的分值评定粗大运动功能;采用Berg平衡量表(BBS)评定平衡功能;采用10 m最大步行速度测试(10MWT)评定步行能力。结果①下肢RMS:与治疗前比较,2组治疗后下肢肌肉腘绳肌、股四头肌、腓肠肌和内收肌RMS均明显降低,差异均具有统计学意义(P<0.05)。与对照组比较,试验组治疗后腘绳肌、股四头肌、腓肠肌和内收肌RMS均明显更低,差异均具有统计学意义(P<0.05)。②下肢肌力:与治疗前比较,2组治疗后髋屈肌、髋伸肌、膝屈肌、膝伸肌、踝背屈肌、踝跖屈肌肌力均明显升高,差异具有统计学意义(P<0.05)。与对照组比较,试验组治疗后髋屈肌、髋伸肌、膝屈肌、膝伸肌和踝跖屈�Objective To observe the effects of game-based integrative neuromuscular training(INT)combined with conventional rehabilitation on children with spastic hemiplegia(SH).Methods A total of 40 children with SH receiving rehabilitation treatment in the Department of Rehabilitation of Children's Hospital Affiliated to Shandong University from January to June 2023 were randomly divided into control group and experimental group using the random number table method,with 20 cases in each group.During the course of the treatment,three cases in the control group dropped out due to early discharge,one case dropped out due to botulinum toxin injection and two cases dropped out due to early discharge in the experimental group.Finally,17 cases were included in each group.The control group received conventional rehabilitation treatment(occupational therapy,paraffin therapy,and low-frequency pulsed electrical stimulation)and conventional motor training(muscle strength training,joint range of motion training,balance training and gait training),20 minutes each item,once a day,five times a week for 12 weeks.The experimental group received game-based integrative neuromuscular training in addition to the the conventional rehabilitation treatment of the control group,including strength training,speed and agility training,dynamic stability training,plyometric training,core stability training,20 minutes a time,once a day,five times a week for 12 weeks.Before and after treatment,BioNeuro biofeedback instrument and Flexcomp Infiniti System surface electromyography analysis system were used to measure and calculate the root mean square(RMS)values of the quadriceps,hamstrings,gastrocnemius and adductor muscles on the affected side under passive stretching;Microfet2 handheld muscle strength tester was used to measure the muscle strength of the hip flexors,hip extensors,knee flexors,knee extensors,ankle dorsiflexors and ankle plantar flexors on the affected side;Gross Motor Function Measure 88(GMFM-88)scores in dimensions D and E were used to

关 键 词：痉挛性偏瘫 整合性神经肌肉训练 体育游戏 运动功能 平衡功能 步行功能 

分 类 号：R742.3[医药卫生—神经病学与精神病学]