Peabody精细运动发育量表在痉挛型脑瘫患儿中的应用

Evaluation of the fine motor functions by PDMS-FM in children with spastic cerebral palsy

目的:探讨Peabody精细运动发育量表(PDMS-FM)在脑瘫儿童精细运动康复评估中的价值。方法:选择3岁以下的痉挛型脑瘫患儿共98例,应用PDMS-FM测定其精细运动功能。用精细运动发育商(FMQ)、抓握能力标准分(sGr)和视觉运动统合能力标准分(SVI)进行分析。结果:sGr、sVI和FMQ在不同类型的脑瘫之间有着非常显著的差异,四肢瘫患儿精细运动功能最差,双瘫患儿较好,而偏瘫患儿介于二者之间,两两比较都有显著性差异。3岁以下脑瘫患儿总体的抓握能力较差而视觉运动统合能力较强(P<0.001),四肢瘫患儿在<12月、12—24月和≥24月三个年龄段中,抓握能力均显著差于视觉运动统合能力(P<0.05);双瘫患儿在<12月组中,抓握能力显著差于视觉运动统合能力(P<0.01),在1岁以上的两组中,二者之间差异没有显著性。偏瘫患儿则在12—24月组中,抓握能力显著差于视觉运动统合能力(P<0.05),在<12月和≥24月组中,二者没有显著差异。结论:PDMS-FM可以很好地反映脑瘫患儿的精细运动功能,在脑瘫的临床分型和治疗工作中有着很好的应用价值。

Objective:To evaluate the fine motor functions of children with spastic cerebral palsy by PDMS-FM (Peabody developmental motor scale-fine motor).Method:98 outpatients below 3 years old with spastic cerebral palsy were involved. Their fine motor functions were measured by PDMS-FM. The FMQ (fine motor quotient), sGr(standard score of grasp) and sVI(standard score of visual-motor integration) were analyzed. Result:The difference between the three groups(tetraplegia,diplegia,hemiplegia) was significant.sVI was significantly better than sGr in all these children(P<0.001).The children with tetraplegia had the worst fine motor functions while the children with diplegia had the best.The children with hemiplegia had middle level of fine motor functions of all.Conclusion:The fine motor functions of children with cerebral palsy can be finely evaluated by PDMS-FM. The PDMS-FM works well in classifying the cerebral palsy.