电刺激治疗脑性瘫痪:对粗大运动被动踝关节活动、足背屈角的作用

Electrical stimulation treatment on cerebral palsy: gross motor function measure,passive activity of ankle joint and foot dorsiflexion angle

背景:目前治疗脑性瘫痪有多种方法,已有研究表明电刺激作为一种新型的治疗方式,现已经应用于脑性瘫痪的治疗,但尚缺乏关于电刺激治疗脑性瘫痪的系统评价发表。目的:评价电刺激治疗脑性瘫痪对粗大运动被动踝关节活动、足背角屈的作用。方法:根据所纳入文献必须是随机对照试验、基线具有可比性及诊断明确的标准,制定文献检索策略,分别检索万方数据库、维普中文科技期刊数据库、中国知网、中国生物医学文献数据库、PubM ed、Ovid数据库,按照Cochrane Reviewer’s Handbook评价文献质量的评价标准,在严格质量评价的基础上,采用RevM an5.1软件对纳入的文献进行分析评价。结果与结论:最终纳入8篇文献。Meta分析结果显示:电刺激治疗组对患者流涎情况的改善(OR=8.37,95%CI:2.86-24.51,P=0.000 1);对腓肠肌痉挛程度的改善(OR=-0.62,95%CI:-0.84至-0.41),P<0.000 01);对粗大运动功能评分的改善D区(站立)功能评分(OR=9.86,95%CI:1.70-18.02,P=0.02);E区(走跑跳)功能评分(OR=9.54,95%CI:7.47-11.62,P<0.000 01);对步行能力的改善(OR=6.12,95%CI:3.65-8.58,P<0.000 01),均明显优于单纯康复治疗的患者。结果证实,电刺激治疗脑性瘫痪在临床方面有效,电刺激治疗脑性瘫痪对粗大运动被动踝关节活动、足背角屈有改善作用,同时联合康复治疗,效果更加显著。

BACKGROUND：There are a variety of therapeutic strategies for cerebral palsy, electrical stimulation has been regarded as a potential treatment of cerebral palsy. However, systemic evaluation of electrical stimulation in treatment of cerebral palsy is rarely reported. OBJECTIVE：To evaluate the effect of electrical stimulation on gross motor function measure, passive activity of ankle joint and foot dorsiflexion angle of cerebral palsy patients. METHODS：A computer-based online retrieval of Wanfang Database, VIP Database for Chinese Technical Periodicals, CNKI Database, Chinese Biomedical Literature Database, PubMed Database, and Ovid Database was performed for randomized control ed trials with comparable baseline and clear diagnosis. The quality of the literatures was strictly evaluated using RevMan5.1 software according to the Cochrane Reviewer’s Handbook. RESULTS AND CONCLUSION：Eventual y 8 papers were included in the Meta analysis. Meta analysis results showed that, electrical stimulation treatment was better than simple rehabilitation in the improvement of patient’s sialorrhea （OR=8.37, 95%CI：2.86-24.51, P=0.000 1）, the degree of gastrocnemius spasm （OR=-0.62, 95%CI：-0.84 to-0.41, P〈0.000 01）, gross motor function score in D area （standing） （OR=9.86, 95%CI：1.70-18.02, P=0.02）, gross motor function score in E area （going, running, jumping） （OR=9.54, 95%CI：7.47-11.62, P〈0.000 01）, and the ability＆nbsp;to walk （OR=6.12, 95%CI：3.65-8.58, P〈0.000 01）. Our findings indicate that, electrical stimulation is an effective treatment on cerebral palsy, it could improve gross motor function measure, passive activity of ankle joint and foot dorsiflexion angle of cerebral palsy patients. The therapeutic effect is more obvious combined with rehabilitation therapy.