康复训练结合电子生物反馈疗法治疗痉挛型脑性瘫痪的随机对照研究

A Randomized Controlled Trial of the Therapeutic Effect of Rehabilitation Training Combined with Electronic Biofeedback Therapy on Spastic Cerebral Palsy

目的探讨康复训练结合电子生物反馈疗法对痉挛型脑性瘫痪(脑瘫)患儿肌张力及关节活动度的影响。方法选取2009年3月—2011年10月我院康复科门诊收治的76例痉挛型脑瘫患儿,采用随机数字表分为试验组和对照组,每组各38例。两组均进行常规康复训练,试验组在康复训练基础上加用电子生物反馈疗法。治疗前和治疗结束后对每例患儿应用改良Ashworth法进行肌张力评定,测量双下肢关节活动度。结果治疗后两组患儿肌张力改善情况比较,差异有统计学意义(u=-2.3808,P=0.0173)。治疗后两组患儿内收肌角、腘窝角、足背屈角改善情况比较,差异均有统计学意义(u值分别为-2.5191、-2.5161、-2.3201,P值分别为0.0118、0.0241、0.0203)。结论应用康复训练结合电子生物反馈疗法治疗痉挛型脑瘫患儿,可明显降低肌张力,扩大双下肢关节活动度,疗效优于单纯康复训练,值得临床推广应用。

Objective To investigate the effect of rehabilitation training combined with electronic biofeedback therapy on muscle tonus and range of motion （ROM） in children with spastic cerebral palsy. Methods 76 children with spastic cerebral palsy admitted into the rehabilitation department from March 2009 to October 2011 were randomly divided into experiment group and control group with each group 38 cases. The two groups were both given routine rehabilitation training and the experiment group was also combined with electronic biofeedback therapy. Muscle tonus and ROM in both lower extremities of the two groups were evaluated by Ashworth method before and after treatment. Results After treatment, the improvement of muscle tonus be- tween the two groups showed statistically significant difference （ u = - 2. 3808, P = 0. 0173 ） . Besides, the improvements of ad- ductor muscle angle, popliteal region angle and activity of instep flexion angle between the two groups all showed statistically sig- nificant differences （u = - 2. 5191, - 2. 5161 and - 2. 3201 respectively, P = 0. 0118, 0. 0241 and 0. 0203 respectively）. Conclusion The combination of rehabilitation training and electronic biofeedback therapy in the treatment of spastic cerebral pal- sy in children can significantly reduce muscle tonus and increase the joint range of motion in both lower extremities and its thera- peutic effect is superior to that of simple rehabilitation training, so it should be promoted in clinic.