不同类型脑性瘫痪儿童粗大运动功能的差异及对策

Differences of gross motor dysfunction in children with spastic and athetoid cerebral palsy

目的:通过对3—7岁的痉挛型和手足徐动型脑性瘫痪(CP)患儿的运动障碍特点进行分析和干预,以探讨该年龄段痉挛型和手足徐动型CP患儿粗大运动功能的差异及对策。方法:对27例痉挛型脑瘫患儿(A组)及12例手足徐动型脑瘫患儿(B组)在入选时及治疗6个月后,分别应用粗大运动功能测量量表(GMFM)进行测量,比较两组入选时,6个月后以及治疗前后各功能区评分的改变。结果:A组患儿在GMFM量表B区、C区、D区、E区得分及总分均较B组为高,A组患儿GMFM涉及上肢的和不涉及上肢的任务的平均分、动态任务的平均分均较B组为高,两组患儿治疗后均较治疗前有改善,差异有显著性(P<0.05);两组患儿GMFM静态任务平均分,治疗前后各区得分和总分改变量差异无显著性(P>0.05)。结论:痉挛型和手足徐动型CP患儿的粗大运动功能表现不同,手足徐动型脑瘫患儿粗大运动功能障碍较痉挛型为重,对于不同类型的脑瘫患儿需针对其运动障碍特点采取不同治疗方式及对策。

Objective： To study the differences of gross motor dysfunction in children with spastic and athetoid cerebral palsy （CP）. Method： Children with spastic （n=27） and athetosis （n=12） CP were assumed by Gross Motor Function Measure （GMFM） at the beginning of enrollment and 6 months after treatment. Result： The B, C, D, E scores and total scores of GMFM were significantly higher in spastic CP group than athetoid CP group（P〈0.05）. The mean scores of motor tasks affected upper limbs and those unaffected upper limbs, and the mean scores of dynamic motor tasks of GMFM in spastic group were significantly higher than athetoid group （P〈0.05）. Significantly improvement GMFM scores were found in both groups after 6 months treatment （P〈0.05）. There was no differences in changes of GMFM scores in both groups （P〉0.05）. Conclusion： There are differences in gross motor function of children with spastic and athetoid CP. The gross motor disability in children with athetoid CP is more severe than those with spastic CP.