功能性肌力训练在痉挛型脑瘫儿童中的应用

The effect of functional strength training in spastic cerebral palsy

目的:观察功能性、闭链的肌力训练对痉挛型脑瘫儿童下肢的运动功能及步行能力的影响。方法:痉挛型脑瘫患儿20例,根据年龄、痉挛分型、运动功能评分进行配对,每对随机分成治疗组和对照组,对照组进行常规的神经发育技术治疗,治疗组在此基础上进行功能性肌力训练,治疗前和治疗6周后评估两组脑瘫患儿粗大运动功能、肌张力、关节活动度、步行能力。结果:治疗组粗大运动功能C、D、E区得分高于对照组(C区58.69±12.85,D区49.74±19.38,E区33.50±17.13,P<0.05),步行能力的改善优于对照组(10m步行时间13.90±5.28s,1min步行距离43.0±12.5m,P<0.05),关节活动度的改善大于对照组(踝背屈角度13.9±3.8°,P<0.05),而肌张力没有明显增加(肌张力平均秩10.50,P>0.05)。结论:功能性下肢肌力训练计划有助于改善脑瘫患儿的运动功能。

Objective：To determine whether functional and closed-chain strength exercise on lower limb improve motor performance in children with spastic cerebral palsy.Method：Twenty children with spastic cerebral palsy were selected for this study.Each child was matched as closely as possible with another child for age, spastic type, and motor function. All were randomly assigned to either the training or control group. The control group received the neurodevelopmental technique （NDT） treatment,the training group received NDT and functional strength training. Measurements of section C,D,E of the Gross Motor Function Measure （GMFM）,muscle tone,passive range of motion （PROM）,and ambulatory ability were made before and after treatment for hoth groups.Result：After six weeks exercise,there were significant improvements in training group compared with the control group on GMFM,on ambulatory ability,on PROM,However. No statistically difference was found in the two groups on muscle tone.Conclusion：A programme of functional strength training is useful for children with cerebral palsy. It has demonstrated increases in motor function,with no increases in spasticity or abnormal movements.