生物刺激反馈仪联合作业疗法治疗臂丛神经损伤临床观察

Clinical observation of biological feedback instrument combined with occupational therapy for brachial plexus injury

目的目前针对臂丛神经损伤患儿多采用生物刺激反馈仪治疗,取得了一定效果,但该疗法易受患儿依从性的影响。本研究观察生物刺激反馈仪联合作业疗法(occupational therapy,OT)对臂丛神经损伤患儿上肢功能与生活质量的影响,旨在为增强疗效提供参考依据。方法将2014-11-01-2017-11-01郑州大学附属儿童医院收治的188例臂丛神经损伤患儿分为研究组和对照组,各94例。研究组采用生物刺激反馈仪+OT治疗,对照组采用生物刺激反馈疗法。分别于治疗前和治疗3个月后评估两组肢体功能,即Mallett肩关节功能评分、Raimondi手功能评分、Glibert肘关节功能评分情况和儿童生存质量普适性核心量表(pediatric quality of life inventoryTM4.0,PedsQLTM4.0)评分情况。结果两组Mallett、Raimondi、Glibert评分组间和时间点比较差异均有统计学意义,Mallett:F_(组间)=3.943,F_(时间)=13.758;Raimondi:F_(组间)=4.852,F_(时间)=15.875;Glibert:F_(组间)=4.716,F_(时间)=14.986;均P<0.001。治疗后,两组Mallett和Raimondi、Glibert评分均较治疗前升高,且研究组大于对照组。两组PedsQLTM4.0各维度评分组间和时间点比较差异均有统计学意义,生理:F_(组间)=8.721,F_(时间)=24.647;情感:F_(组间)=8.544,F_(时间)=25.713;社会:F_(组间)=11.213,F_(时间)=29.765;角色:F_(组间)=9.113,F_(时间)=26.747;均P<0.001。两组PedsQLTM4.0各维度评分均较治疗前升高,且研究组升幅大于对照组。结论生物刺激反馈仪联合OT可显著改善臂丛神经损伤患儿上肢功能和生活质量,于促进患儿疾病恢复有利。

OBJECTIVE At present,children patients with brachial plexus injury treated with biological feedback instrument have achieved some effects.But the therapy is susceptible to the compliance of children patients.This study is to investigate the effects of biological feedback instrumentcombined with occupational therapy(OT)on upper limb function and quality of life in children patients with brachial plexus injury in order to help enhance the efficacy.METHODS A total of 188 cases of children patients with brachial plexus injury collected from November 1,2014 to November 1,2017 were divided into biological feedback instrument plus OT group(study group,n=94)and biological feedback instrument feedback therapy group(control group,n=94)according to the random number table method.The limb function(Mallett shoulder function score,Raimonti hand function score,Glibert elbow joint function score)and quality of life [Pediatric Quality of Life Inventory TM 4.0(PedsQLTM 4.0)]were assessed in the two groups before treatment and after3 months of treatment.RESULTS There were significant differences between the two groups in the scores of Mallett,Raimondi and Glibert at between-groups and between-time points(Mallett:Fbetween-groups=3.943,Ftime=13.748;Raimondi:Fbetween-groups=4.852,Ftime=15.875;Glibert:Fbetween-groups=4.716,Ftime=14.986;all P<0.001).After treatment,the scores of Mallett,Raimondi and Glibert in the two groups were higher than those before treatment,and the scores in study group were greater than those in control group.There were significant differences between the two groups in the dimensions scores of PedsQLTM4.0(physiology:Fbetween-groups=8.721,Ftime=24.647;emotion:Fbetween-groups=8.544,Ftime=25.713;society:Fbetween-groups=11.23,Ftime=29.765;role:Fbetween-groups=9.113,Ftime=26.747;all P<0.001).The dimensions scores of PedsQLTM 4.0(physiology,emotion,society and role)in the two groups were higher than those before treatment,and the increase in study group was greater than that in control group.CONCLUSIONS Biological feedback instrument combined with OT can significantly improve the upper limb function and it is beneficial to promote the recovery of disease.