肌电生物反馈综合治疗促进痉挛性双瘫型脑瘫患儿下肢运动功能的疗效观察

Effect of nerve rehabilitation reconstruction therapy on lower extremities motor function in children with spastic diplegic cerebral palsy

目的:观察神经康复重建疗法治疗痉挛性双瘫型脑瘫患儿下肢运动功能障碍的疗效。方法:24例痉挛性双瘫型脑瘫患儿随机分为治疗组和对照组,每组12例,所有患儿均接受Bobath技术、推拿、脑循环治疗。治疗组在以上基础上应用WOND2000F2型神经康复重建仪,对双下肢进行肌电触发的生物反馈刺激。在疗程开始与结束时,用改良的Ashworth量表测定患儿腓肠肌肌张力的变化、用关节量角器测量踝关节被动活动的角度变化,采用粗大运动功能测量量表(GMFM)中D和E功能区进行站立与步行功能评定。结果:治疗后,两组患儿的观察指标均有不同程度改善(P<0.01—0.001),但治疗组疗效优于对照组(P<0.05—0.01)。结论:神经康复重建治疗能降低痉挛性双瘫型脑瘫患儿的下肢肌张力,增加胫前肌肌力和踝关节活动度,明显提高下肢运动功能。

Objective： To investigate the effect of nerve rehabilitation reconstruction therapy on lower extremities motor function in children with spastic diplegic cerebral palsy （CP）. Method： Twenty-four spastic diplegic CP children were randomly divided into treatment group and control group with 12 cases in each group. All children were treated with Bobath technique, tuina and cerebral circulation therapy, while those of treatment group were added electromyographic biofeedback therapy combined with EMG- electrical stimulation by nerve rehabilitation reconstruction instrument. The modified Ashworth scale was performed to evaluate the muscle tone of lower limbs, and other clinical evaluations were performed to assess the range of passive motion with orthrometer and the motor function with gross motor function measure （GMFM）. Result： The lower extremities function of all children in two groups improved in different extent （P〈0.01--0.001） and the effect of treatment group was superior to that of control group （P〈0.05--0.01）. Conclusion： The nerve rehabilitation reconstruction therapy consisted of electromyographic biofeedback therapy combined with EMG-electrical stimulation in the treatment for children with spastic diplegic cerebral palsy can decrease the muscle tone and improve the range of passive motion, as well as the motor function of lower extremities.