基于ICF-CY核心分类组合的康复治疗方案对脑性瘫痪患儿日常生活能力影响的前瞻性随机对照研究

Effect of rehabilitation treatment based on the ICF-CY Core Sets on activities of daily living in children with cerebral palsy: a prospective randomized controlled study

目的探讨基于《国际功能、残疾和健康分类(儿童与青少年版)》(International Classification of Functioning,Disability and Health,Children and Youth Version,ICF-CY)核心分类组合的康复治疗方案对脑性瘫痪患儿日常生活能力的影响。方法采用随机数字表法将脑性瘫痪患儿分为观察组(n=63)及对照组(n=59)。观察组康复团队利用ICF-CY核心分类组合<6岁简明版对入组患儿进行评估,根据结果明确靶干预点并制定康复计划和目标,选择具体方法进行康复治疗;对照组康复团队采用传统的康复模式进行评估与治疗。对两组患儿在治疗前和治疗3个疗程后进行儿童功能独立性评定量表(Functional Independence Measure for Children,WeeFIM)、婴儿-初中生社会生活能力量表评分,并对两组患儿环境因素干预情况进行统计学分析。结果治疗前两组患儿WeeFIM、社会生活能力评分差异均无统计学意义(P>0.05)。治疗后两组组内WeeFIM、社会生活能力评分均显著高于治疗前(P<0.001)。治疗后观察组WeeFIM、社会生活能力评分均显著高于对照组(P<0.05)。环境因素方面,两组患儿在矫形器适配方面差异无统计学意义(P>0.05),在生活自助、移乘、交流类辅助器具和设施改造、家庭康复方面,观察组干预比例均高于对照组(P<0.05)。结论基于ICF-CY核心分类组合的康复治疗方案更加注重康复过程中环境因素的影响,能有效提高脑性瘫痪患儿日常生活能力。[中国当代儿科杂志,2021,23 (6):608-612]

Objective To study the effect of rehabilitation treatment based on the International Classification of Functioning, Disability and Health-Children and Youth Version(ICF-CY) Core Sets on activities of daily living in children with cerebral palsy. Methods The children with cerebral palsy were divided into an observation group(n=63)and a control group(n=59) using a random number table. The children in the observation group were evaluated using the brief ICF-CY Core Sets for children under 6 years to identify intervention targets and develop rehabilitation plans and goals, and then specific methods were selected for rehabilitation treatment. The children in the control group were evaluated and treated with the traditional rehabilitation mode. The scores of the Functional Independence Measure for Children(WeeFIM) and the Infants-Junior Middle School Students’ Social-Life Abilities Scale were assessed for both groups before treatment and after three courses of treatment. The intervention of environmental factors was compared between the two groups. Results There was no significant difference in the scores of the WeeFIM and Social-Life Abilities scales between the two groups before treatment(P>0.05). After treatment, both groups had significant increases in the scores of the WeeFIM and Social-Life Abilities scales(P<0.001). The observation group had significantly higher scores of WeeFIM and Social-Life Abilities scales than the control group after treatment(P<0.05). There was no significant difference in the use rate of orthosis between the two groups(P>0.05), but the use rate of assistive devices for self-help, transfer and communication, the rate of facility renovation, and the rate of family rehabilitation guidance in the observation group were significantly higher than those in the control group(P<0.05). Conclusions The rehabilitation treatment regimen for cerebral palsy based on the CF-CY Core Sets pays more attention to the influence of environmental factors in the process of rehabilitation and can effectively improve the activities of daily living of children with cerebral palsy. [Chinese Journal of Contemporary Pediatrics, 2021, 23(6): 608-612]