体外反搏联合多功能悬吊训练对痉挛型脑瘫患儿粗大运动功能的影响

Effect of external counterpulsation combined with multifunctional suspension training on gross motor function in children with spastic cerebral palsy

目的探讨体外反搏治疗联合多功能悬吊训练对痉挛型脑瘫患儿粗大运动功能的影响及治疗效果。方法选取2019年1月至2021年1月上海市交通大学附属儿童医院康复中心诊断为痉挛型脑瘫儿的42例为研究对象。将患儿随机分为对照组和观察组,每组21例。对照组只采用每周3次多功能悬吊训练(40 min/次),观察组每周3次多功能悬吊训练(40 min/次)联用体外反搏治疗(60 min/次)。两组均以3个月为1个疗程,总计治疗2个疗程。以粗大运动功能测试量表(GMFM-88)和Berg平衡量表(BBS)及改良Ashworth下肢肌张力分级进行评定,比较两组患儿粗大运动功能、平衡功能和肌张力改善情况。结果经过6个月治疗,两组患儿粗大运动GMFM-88评分、BBS评分均较治疗前显著提高(P<0.01),且治疗后观察组GMFM-88评分[(64.72±19.62)分vs(53.22±13.79)分,P<0.01]、BBS评分[(13.38±5.71)分vs(11.19±4.56)分,P<0.05]均显著高于对照组。治疗后观察组下肢肌张力疗效稍高于对照组,但差异无统计学意义(90.48%vs 66.67%,P>0.05)。结论应用体外反搏联合多功能悬吊训练对痉挛型脑瘫患儿进行综合康复治疗,能有效改善患儿的粗大运动功能、平衡功能,有利于降低肌张力。

Objective To explore the effects of external counterpulsation treatment combined with multifunctional suspension training on gross motor function of children with spastic cerebral palsy(CP).Methods Forty-two children with spastic cerebral palsy confirmed in rehabilitation center of Children s Hospital of Shanghai Jiaotong University from January 2019 to January 2021 were selected as the research subjects and randomly divided into control group and observation group(n=21,each).Multifunctional suspension training was conducted three times a week(40 min/time)in control group,and external counterpulsation treatment was performed three times a week(60 min/time)based on multifunctional suspension training in observation group.In both groups,one course of treatment lasted for 3 months,with two courses of total treatment for all patients.Gross motor ability,balance function and muscle tension were evaluated by gross motor function test scale(GMFM-88),Berg balance scale(BBS)and modified Ashworth assessment(MAS)of muscle tension of lower limbs and compared between two groups.Results After 6 months of treatment,GMFM-88 and BBS significantly increased compared with those before treatment in two groups(P<0.01),and GMFM-88 score[(64.72±19.62)vs(53.22±13.79),P<0.01]and BBS[(13.38±5.71)vs(11.19±4.56),P<0.05]in observation group were statistically higher than those in control group.After treatment,the total effective rate for lower limb muscle tension in observation group was better than that in control group,but there was no statistical difference in it(90.48%vs 66.67%,P>0.05).Conclusion In the comprehensive rehabilitation for children with spastic cerebral palsy,external counterpulsation combined with multifunctional suspension training can effectively improve the gross motor ability,balance function and muscle tension.