小于3岁痉挛型脑性瘫痪儿童粗大运动与精细运动发育的相关性研究

The correlation between gross motor function and fine motor function in young children with spastic cerebral palsy

目的比较小于3岁痉挛型脑性瘫痪儿童粗大运动与精细运动发育之间的相关性。方法以同时接受粗大运动功能测试量表（GMFM）评定和精细运动功能评定量表（FMFM）评定的193例小于3岁的痉挛型脑性瘫痪儿童为研究对象，比较GMFM各项分值与FMFM分值在不同月龄和类型患儿中的相关程度，通过多元逐步回归分析确定GMFM5个功能区分值对FMFM分值的影响程度。结果在不同月龄和类型的脑性瘫痪患儿中，GMFM各项分值与FMFM分值具有良好的相关性（r=0．26～0．85，P〈0．05），多元逐步回归分析结果显示GMFM的A区和B区分值对FMFM分值的影响力较大，校正决定系数为0．748，A区的作用更为强烈。结论小于3岁的痉挛型脑性瘫痪儿童的粗大运动与精细运动存在着良好的相关性，对不同年龄和类型的脑性瘫痪儿童都应该重视粗大运动与精细运动训练相结合，同时必须加强基本运动功能训练。

Objective To evaluate the correlation between gross motor function （GMF） and fine motor function （FMF） in children less than 3 years old who have spastic cerebral palsy （SCP）. Methods One hundred and ninety-three children less than 3 years old with SCP were assessed with the Gross Motor Function Measure（ GM- FM） and the Fine Motor Function Measure （FMFM）. The relationship between the GMFM and FMFM scores was analyzed according to ages and CP types. The multivariate associations between FMFM scores and the five explanatory variables （scores on the five GMFM dimensions） were examined using stepwise regression. Results There was excellent correlation between the GMFM and FMFM scores by age and CP type. Stepwise regression showed that GMFM dimensions A and B were significant predictors of FMFM scores. Conclusion Gross MF is closely related to fine MF in spastic children less than 3 years old. It is very important that they receive combined gross motor and fine motor training, as well as basic motor function training.