痉挛型脑性瘫痪儿童运动功能远程家庭康复应用研究

Application study on remote home rehabilitation of motor function in children with spastic cerebral palsy

目的:探究远程家庭康复对痉挛型脑性瘫痪(脑瘫)儿童运动功能的影响。方法:本研究选取出院的痉挛型脑瘫儿童40例,随机分成常规家庭康复组(对照组)和远程家庭康复组(观察组),每组20例。常规家庭康复组患儿按照康复治疗团队制定的家庭康复方案,接受家庭康复训练;远程家庭康复组患儿按照康复治疗团队制定的个体化远程家庭康复方案,通过远程视频方式,定期通过视频随访问诊及指导,在家属帮助下进行家庭康复训练。在治疗前和治疗12周后,对2组患儿使用粗大运动功能评定量表(gross motor function measure,GMFM)、Berg平衡量表(berg balance scale,BBS)、改良Ashworth肌张力评定量表(modified Ashworth muscular tension assessment scale,MAS)以及踝关节关节活动度测量(range of motion,ROM)予以评定。结果:治疗前两组患儿GMFM、BBS、MAS以及踝关节ROM比较无显著性差异(P>0.05);进行为期12周的康复训练后,两组患儿运动功能、平衡功能、关节活动度较治疗前均有明显改善(P<0.05),肌张力明显降低(P<0.05);远程家庭康复组患儿运动功能、平衡功能、踝关节关节活动度、肌张力改善效果优于常规家庭康复组(P<0.05)。结论:远程家庭康复可有效改善痉挛型脑瘫儿童运动功能。

Objective:To study the influence of individualized family rehabilitation on motor function of children with spastic cerebral palsy.Method:Forty children discharged from hospital with spastic cerebral palsy were randomly divided into routine family rehabilitation group and remote family rehabilitation group,with 20 patients in each group.The children in routine family rehabilitation group received routine rehabilitation training under the guidance of the therapist.Under the supervision of their families,the children in the remote family rehabilitation group were be followed-up,inquired,guided and trained regularly with the help of their family members at home by remote video according to the individual program developed by the rehabilitation treatment team.In the beginning and after 12 weeks,the gross motor function measure(GMFM),Berg balance scale(BBS),modified Ashworth muscular tension assessment scale(MAS)and ankle joint range of motion(ROM)were used to evaluate the motor function,balance and joint range of motion.Result:There was no significant difference in GMFM,BBS,MAS and ankle joint ROM between the two groups before treatment(P>0.05).After rehabilitation training for 12 weeks,motor function,balance and joint range of motion were significantly improved(P<0.05),and muscle tone was significantly reduced(P<0.05).The improvement of motor function,balance,range of motion and muscle tension in the remote family rehabilitation group was better than that in the routine family rehabilitation group(P<0.05).Conclusion:Individual remote family rehabilitation can improve motor function of children with spastic cerebral palsy.