抑强扶弱推拿法对痉挛型脑性瘫痪儿童上肢功能影响的临床研究

Clinical study on the effect of massage therapy on upper limb function in children with spastic cerebral palsy

目的:观察抑强扶弱推拿法对痉挛型脑性瘫痪儿童上肢功能的影响。方法:将符合纳入标准的90例痉挛型脑性瘫痪儿童随机分为治疗组和对照组,每组45例,治疗组采用抑强扶弱推拿法,对照组采用常规推拿法。两组均给予基础综合康复训练(运动疗法、作业疗法、物理因子疗法等)。在治疗前及治疗8周后,运用徒手肌力评定量表(MMT)、改良Ashworth量表(MAS)、Peabody运动发育量表第2版(PDMS-2)和表面肌电信号均方根平均值(RMS Mean)评估患儿上肢功能,并进行组间比较。结果:治疗组总有效率88.6%,对照组总有效率为79.1%,治疗组高于对照组(P<0.05);两组治疗后上肢徒手肌力评分、肌张力评分、精细运动发育商均有所改善(P<0.05),治疗组改善程度优于对照组(P<0.05)。结论:两组治疗方法均能改善痉挛型脑瘫儿童的上肢肌力、肌张力及精细运动能力;抑强扶弱推拿法疗效优于常规推拿法,可在临床推广应用。

Objective: To observe the effect of the massage therapy on upper limb function of children with spastic cerebral palsy.Method:Ninety children with spasmodic cerebral palsy who met the inclusion criteria were randomly divided into treatment group and control group, 45 cases per group. The treatment group was treated with massage suppressing the strong and helping the weak. The control group was treated with routine massage. Both groups were given with basic comprehensive rehabilitation training(exercise therapy, occupational therapy, physical agents therapy, etc). Before and after 8 weeks of treatment,bare-handed muscle strength assessment(MMT),modified Ashworth Scale(MAS),Peabody motor development scale version 2(PDMS-2) and surface electromyogram were used to assess upper limb function improvement.Result:The total effective rate of the treatment group was 88.6%,and the total effective rate of the control group was 79.1%. The treatment group was higher than the control group(P<0.05);the scores of above tests were improved after treatment(P<0.05) in both groups,but the improvement of the treatment group was better than those of the control group(P<0.05).Conclusion:Both methods can improve upper limb muscle strength,muscle tension and fine movement ability of children with spastic cerebral palsy,and the effect of suppressive and weak massage is better than that of conventional massage,which can be popularized and applied in clinic.