静态渐进性牵伸对痉挛型脑性瘫痪患儿尖足疗效的观察

Effects of static progressive stretch on tiptoes in children with spastic cerebral palsy

目的:观察静态渐进性牵伸治疗对痉挛型脑瘫患儿尖足的疗效。方法:60例(年龄4—12岁)痉挛型脑瘫患儿随机分为观察组(30例)和对照组(30例),观察组进行静态渐进性牵伸治疗,再配合常规康复治疗。对照组仅进行常规康复治疗。治疗前后,两组分别进行踝关节背屈活动度(ROM)、小腿三头肌肌张力评分(MAS)和GMFM量表D区(站立)、E区(走跑跳)评估。结果:两组治疗前踝关节ROM、肌张力和GMFM量表D、E区评分间差异均无显著性(P>0.05),治疗3个月后,两组各项指标较治疗前均改善(P<0.05),且以观察组的改善幅度较为显著,与对照组比较,组间差异有显著性(P<0.05)。结论:静态渐进性牵伸治疗配合常规康复治疗能增加痉挛型脑瘫患儿踝关节背屈活动度,降低小腿三头肌肌张力,提高患儿站立和走跑跳的运动功能。

Objective： To observe the effect of static progressive stretch on tiptoe in children with spastic cerebral palsy. Method： Sixty children（aged 4—12 years）with spastic cerebral palsy were randomly divided into observation group（n=30） and control group （n=30）. Observation group accepted static progressive stretch combined with comprehensive rehabilitation training. Control group accepted comprehensive rehabilitation training. All children were assessed with range of motion （ROM） of ankle, spasticity of triceps surae （modified Ashworth scale, MAS） and D （Standing） and E （Walking, Running ＆ Jumping） domains of Gross Motor Function Measure （GMFM-66） before and 3 months after the treatment. Result： No statistically difference was found in ROM of ankle, MAS and scores of D and E domains of GMFM before treatment between the two groups （P〉0.05）. After 3 months of treatment, the indexes of the two groups were significantly improved compared with those before treatment （P〈0.05）, and the observation group was superior to the control group （P〈0.05）. Conclusion：Static progressive stretch in combination with the comprehensive rehabilitation training can increase ROM of ankle, decrease MAS of triceps surae, and improve the motor function of standing, walking, running and jumping in children with spastic cerebral palsy.