任务导向训练对脑瘫患儿运动功能影响的Meta分析

Meta-analysis of the effect of task oriented training on motor dysfunction in children with cerebral palsy

目的系统评价任务导向训练对脑瘫患儿运动功能障碍的治疗效果。方法检索The CochraneLibrary、PubMed、Springer Link、WebofScience、中国知网、中国生物医学文献服务系统、维普网、万方数据、百度学术、谷歌学术等数据库中关于任务导向治疗运动功能障碍的随机对照试验,采用Rev-Man 5.3软件进行Meta分析。结果纳入10项随机对照试验,共516例病例,其中观察组259例,对照组257例。观察组与对照组粗大运动功能评定量表(gross motorfunctionmeasure,GMFM)总分(MD=9.93,95%CI=7.29~12.57)、GMFM D区得分(MD=1.98,95%CI=0.65~3.31)、儿童残疾评定量表(pediatiic evaluationofdisabilityinventory,PEDI)得分(MD=6.44,95%CI=3.86~9.03),差异均有统计学意义(P<0.05),而GMFM E区得分(MD=2.34,95%CI=-0.45~5.13,P=0.10)差异无统计学意义。结论任务导向训练在改善脑瘫患儿运动功能障碍方面具有一定效果,但本研究纳入的文献样本量偏少,质量总体偏低,因此,需更多高质量的随机对照双盲试验进一步验证任务导向训练治疗脑瘫运动功能障碍的疗效。

Objective To evaluate the effect of task oriented training on motor dysfunction in children with cerebral palsy.Methods Searched the Cochrane Library,PubMed,Springer Link,Web of Science,CNKI,China Biomedical Literature Service System,VIP,Wanfang Data,Baidu Scholar,Google Scholar and other databases for randomized controlled trials of task oriented training for motor dysfunction Meta-analysis was performed using Rev-Man 5.3 software.Results 10 randomized controlled trials with a total of 516 cases were included,including 259 cases in the observation group and 257 cases in the control group.Gross motor function measure(GMFM)total score of observation group and control group(MD=9.93,95%CI=7.29-12.57),GMFM D zone score(MD=1.98,95%CI=0.65-3.31),pediatric evaluation of disability inventory(PEDI)score(MD=6.44,95%CI=3.86-9.03)between observation group and control group,the difference was statistically significant(P<0.05),while the GMFM E area score(MD=2.34,95%CI=-0.45-5.13,P=0.10)between observation group and control group,the difference was not statistically significant.Conclusion Task oriented training has certain effect in improving motor dysfunction in children with cerebral palsy,and it is very interesting.However,the sample size of the lit-erature included in this study is relatively small and the quality is generally low.Therefore,more high quality randomized controlled double-blind trials are needed for further study.To verify the efficacy of task oriented training in the treatment of motor dysfunction in cerebral palsy task.