头针运动疗法结合康复治疗对痉挛型脑瘫患者关节活动度及日常生活活动能力的影响

Effect of Kinesiotherapy-combined Scalp Acupuncture plus Rehabilitation on the Joint Range of Motion and Activities of Daily Life in Spastic Cerebral Palsy

目的观察头针运动疗法结合常规康复治疗对痉挛型脑瘫患者关节活动度及日常生活活动能力(ADL)的影响。方法将51例符合纳入标准的痉挛型脑瘫患者按随机数字表法分为治疗组23例和对照组28例。对照组患者接受常规康复治疗,治疗组在对照组基础上采用头针运动法治疗。治疗前和治疗后,两组患者均采用关节量角器测量踝关节、膝关节及髋关节被动活动的角度;采用改良Ashworth量表测定下肢肌群内收肌、腘绳肌和腓肠肌的肌张力;采用ADL评定量表进行日常生活活动能力的评定。结果治疗组治疗后患者关节活动度较治疗前均有不同程度改善(P<0.05),且治疗组患者腘窝角和足背屈角与对照组比较差异均有统计学意义(P<0.05)。治疗组治疗后患者腘绳肌及腓肠肌肌张力与治疗前比较差异均有统计学意义(P<0.05);治疗组患者腓肠肌肌张力变化与对照组比较差异有统计学意义(P<0.05);治疗组治疗后患者ADL变化与对照组比较差异有统计学意义(P<0.05)。结论头针运动疗法结合常规康复治疗可以显著改善痉挛型脑瘫患者的关节活动度及ADL。

Objective To observe the effect of kinesiotherapy-combined scalp acupuncture plus rehabilitation on the joint range of motion（ROM） and activities of daily life（ADL） in kids with spastic cerebral palsy. Method Fifty-one eligible patients with spastic cerebral palsy were divided into a treatment group of 23 cases and a control group of 28 cases by the random number table. The control group received conventional rehabilitation, whereas the treatment group received kinesiotherapy-combined scalp acupuncture in addition to the rehabilitation therapy. Before and after treatment, a joint protractor was used to measure the passive ROM of ankle, knee, and hip joints; the Modified Ashworth Scale was used to evaluate the muscular tension of the adductor muscles of lower limbs, hamstring muscles, and gastrocnemius; the scale for ADL was adopted to evaluate the ADL. Result The joint ROM was significantly improved by different degrees in the treatment group after intervention（P〈0.05）, and the popliteal angle and dorsal flexion of foot in the treatment group were significantly different from that in the control group（P〈0.05）. In the treatment group, the muscular tension of hamstring muscles and gastrocnemius after treatment was significantly different from that before treatment（P〈0.05）; the change of the muscular tension of gastrocnemius in the treatment group after intervention was significantly different from that in the control group（P〈0.05）; the change of ADL in the treatment group after intervention was significantly different from that in the control group（P〈0.05）. Conclusion Kinesiotherapy-combined scalp acupuncture plus conventional rehabilitation can markedly improve the ROM and ADL in patients with spastic cerebral palsy.