家庭康复运用CIMT对偏瘫型脑性瘫痪患儿上肢功能恢复的影响

Home-based constraint induced movement therapy(CIMT) on recovery of upper limb function in children with hemiplegic cerebral palsy

目的探讨家庭康复中运用强制性诱导运动疗法(CIMT)对偏瘫型脑瘫患儿上肢功能恢复的影响。方法将偏瘫型脑瘫患儿62例分为CIMT组与对照组,两组均接受普通康复训练,CIMT组在此基础上还接受CIMT治疗。采用以下量表对治疗疗效进行评定并比较两组结果,包括Fugl-Meyer运动功能评定量表(FMA)上肢部分(FMA-UE)、运动功能评估量表(MAS)上肢部分(MAS-UE)、Carroll上肢功能试验(UEFT)及日常生活活动能力(ADL)量表(Barthel指数)。结果治疗10周后,两组的FMA-UE、MAS-UE、UEFT评分及Barthel指数均较治疗前提高(P均<0.05),且CIMT组疗效优于对照组(FMA-UE:31.44±12.26 vs.25.52±10.71;MAS-UE:5.96±4.50 vs.3.65±4.48;UEFT:53.35±5.43 vs.42.44±2.10;Barthel指数:59.48±5.45 vs.56.41±4.75)(P均<0.05)。结论家庭康复中运用CIMT有助于偏瘫型脑性瘫痪患儿上肢功能的恢复。

Object To observe the effect of home-based constraint-induced movement therapy （CI-MT） on upper limb function in children with hemiplegic cerebral palsy. Method Sixty-two patients with hemiplegic cerebral palsy were divided into CIMT group and control group. Both groups were treated with common rehabilitation training,with an extra CIMT training in the former group. The effects were evaluated and compared with fugl-meyer assessment-upper extremity （FMA-UE ）,motor assessment scale-upper extremity （MAS-UE）,upper extremity function test （UEFT）,barthel index were applied to evaluate upper limb function and activity of daily living in two groups before and after treatment. Results After 1 0 weeks of treatment, the scores of FMA-UE,MAS-UE,UEFT and Barthel index of both groups were improved obviously （P〈0.05 ）. The treatment effect of CIMT group was significantly better than that of the control group （FMA-UE：31.44 ±1 2.26 vs. 25.52 ±1 0.71;MAS-UE：5.96 ±4.50 vs. 3.65 ±4.48;UEFT：53.35 ±5.43 vs.42.44 ±2.10;Barthel index：59.48 ±5.45 vs. 56.41 ±4.75）（P〈0.05）. Conclusion CIMT is helpful to improve the upper limb function of children with hemiplegic cerebral palsy.