引导式教育结合运动疗法对脑性瘫痪患儿康复功能的影响

Effect of Conductive Education Combined with Exercise Therapy on Rehabilitation Function of Children with Cerebral Palsy

目的:分析引导式教育结合运动疗法对脑性瘫痪(简称脑瘫)患儿的康复成效,为脑瘫患儿的优质诊疗照护提供循证依据。方法:将我院收治的100例脑瘫患儿按照随机数字表法分为研究组和对照组,每组各50例。2组均接受运动疗法,包括上肢功能运动疗法、摄食行为运动疗法、双耳杯应用运动疗法、膳食管理;研究组在对照组基础上开展引导式教育,包括认知层面的引导式管理、引导式情感放松性冥想。在干预前与干预后第4周末,2组均接受日常生活活动能力(ADL)量表调查;采用BSID智力发育量表对2组的运动功能发育水平和智力发育指数进行比较;采用DQ智商量表对2组的大动作、语言、精细动作、社会行为、适应能力5项智商值进行比较;对2组摄食行为的效果进行评价,根据其摄食时的行为表现和摄食时间进行效果划分。结果:2组在干预后的ADL评分相较于干预前均有所改善,研究组干预后的ADL评分为(85.7±6.3)分,高于对照组(67.5±4.2)分,差异有统计学意义(P<0.05)。研究组干预后的运动功能发育水平及智力发育指数分别为(98.4±7.9)分、(99.1±8.4)分,均高于对照组(87.4±6.6)分、(94.6±7.0)分,同时2组在干预后的运动功能发育水平及智力发育指数均高于干预前,差异均有统计学意义(P<0.05)。研究组干预后的DQ智商得分分别为(96.3±7.9)分、(100.8±9.2)分、(97.6±10.4)分、(101.6±8.4)分、(98.5±7.8)分,均高于对照组(83.2±6.9)分、(86.0±8.5)分、(84.1±9.4)分、(84.3±7.1)分、(83.2±7.0)分,差异有统计学意义(P<0.05)。研究组患儿摄食行为有效率为96.00%(48/50),高于对照组84.00%(42/50),差异有统计学意义(P<0.05)。结论:引导式教育结合运动疗法应用于脑瘫患儿,能促进支配患儿躯体功能的日常活动行为重塑,且能促进患儿心智水平发育,利于个体病情康复。随着脑瘫患儿对外部世界内化度的深化,能提高个体的精神情感水平,最终可实现患儿病情的整体化发展。

Objective: To analyze the rehabilitation effect of conductive education combined with exercise therapy on children with cerebral palsy and provide evidence-based support for the high-quality diagnosis, treatment and care of such groups. Methods: A total of 100 children with cerebral palsy admitted to our hospital were divided into study group and control group by random number table, with 50 cases in each group. Both groups received exercise therapy, including upper limb function exercise, eating behavior exercise, binaural cup exercise, and dietary management;while the study group carried out conductive education on the basis of the control group, including cognitive level conductive management, conductive emotional relaxing meditation. Before and at the 4th weekend after the intervention, activity of daily living (ADL) scale was used in the two groups. At the each time points, BSID intelligence development scale was used as a measurement tool to compare the motor function development level and intelligence development index of the two groups. At the each time points, DQ intelligence consultation table was used as a measurement tool, which includes big action IQ, language IQ, fine action IQ, social behavior IQ and adaptability IQ. The effects of two groups on feeding behavior were evaluated, and the effects were divided according to their feeding behavior and feeding time. Results: The ADL scores of two groups after intervention were improved compared with those before intervention. The ADL scores of the study group after intervention were (85.7±6.3), higher than those of the control group (67.5±4.2), the difference was statistically significant (P<0.05). The motor function development level and intelligence development index of the study group after intervention were (98.4±7.9) and (99.1±8.4) respectively, which were higher than those of the control group (87.4±6.6) and (94.6±7.0). The motor function development level and intelligence development index of the two groups after intervention were higher than those before intervention, and the differences were statistically significant (P<0.05). The DQ IQ scores of the study group after intervention were (96.3±7.9),(100.8±9.2),(97.6±10.4),(101.6±8.4) and (98.5±7.8) respectively, which were higher than those of the control group (83.2±6.9),(86.0±8.5),(84.1±9.4),(84.3±7.1) and (83.2±7.0), and the differences were statistically significant (P<0.05). The effective rate of feeding behavior was 96.00%(48/50) in the study group, which was higher than 84.00%(42/50) in the control group (P<0.05). Conclusion: Conductive education combined with exercise therapy in children with cerebral palsy can promote the daily activities and behavior that dominate the physical function of children, and promote the development of mental level of children with cerebral palsy, which is conducive to the rehabilitation of individual condition. With the deepening of internalization of the external world, children with cerebral palsy can improve their individual mental and emotional level, and ultimately achieve the integrated development of children's condition.