引导式教育结合运动疗法对脑性瘫痪患儿康复疗效的研究

Study on the efficacy of utilizing conductive education combine with kinesiotherapy in children with cerebral palsy

目的研究引导式教育结合运动疗法对脑性瘫痪患儿运动功能和日常生活能力的康复疗效。方法将2018年1月至2019年1月80例在石家庄市人民医院首次就诊的1~8岁脑性瘫痪患儿按照年龄分为两组,<3岁为婴幼儿组(n=20),≥3岁为儿童组(n=60),两组患儿再按随机数字表法各分为研究组及对照组,其中研究组应用引导式教育+运动疗法治疗,对照组单独应用运动疗法治疗。研究组与对照组分别比较治疗前后粗大运动功能量表88项(gross motor function measure-88,GMFM-88)和儿童生活功能评估量表(pediatric evaluation of disability inventory,PEDI)自理能力部分评分。采用t检验、χ^(2)检验及Fisher精确检验进行统计学分析。结果婴幼儿中GMFM-88及PEDI(自理能力部分)评分比较,研究组和对照组治疗前GMFM-88评分比较差异无统计学意义(P>0.05),两组治疗3个月后GMFM-88评分研究组为(142±16)分,对照组为(138±14)分,均明显高于治疗前,且研究组优于对照组,差异有统计学意义(P<0.05)。两组治疗前PEDI(自理能力部分)评分比较差异无统计学意义(P>0.05),治疗3个月后PEDI(自理能力部分)评分研究组为(31±8)分,对照组为(27±6)分,均明显高于治疗前,且研究组优于对照组,差异有统计学意义(P<0.05)。儿童中GMFM-88及PEDI(自理能力部分)评分比较,研究组和对照组治疗前GMFM-88评分比较差异无统计学意义(P>0.05),治疗3个月后GMFM-88评分研究组为(178±21)分,对照组(169±17)分,均明显高于治疗前,且研究组优于对照组,差异有统计学意义(P<0.05);两组治疗前PEDI(自理能力部分)评分比较差异无统计学意义(P>0.05),治疗3个月后PEDI(自理能力部分)评分研究组为(41±8)分,对照组为(35±6)分,均明显高于治疗前,且研究组优于对照组,差异有统计学意义(P<0.05)。结论引导式教育结合运动疗法能提高脑性瘫痪患儿的运动功能和日常生活能力,疗效显著优于单用运动疗法,值得临床进一步推广应用。

Objective To observe the efficacy of conductive education combined with kinesiotherapy on motor function and daily living ability of children with cerebral palsy.Method From January 2018 to January 2019,80 children aged 1-8 years who were diagnosed cerebral palsy in Shijiazhuang People's Hospital for the first time were divided into two groups:children younger than 3 years were infants group(n=20),children older than 3 years or equal were children's group(n=60).Two groups were further divided into study group and control group according to the randomized digital table method.The study group applied conductive education and kinesiotherapy,and the control group were treated with kinesiotherapy alone.The gross motor function measure-88(GMFM-88)and the part of self-care ability of pediatric evaluation of disability inventory(PEDI)before and after treatment in two groups were compared respectively.t-test,χ^(2) test and Fisher exact test were used for statistical analysis.Result In infants,there were no difference before treatment in the scores of GMFM-88 between the two groups(P>0.05).The GMFM-88 score was significantly higher after 3 months of treatment than before treatment,the study group was(142±16)points,the control group was(138±14)points,and the score of study group was better than that of control group.The difference was statistically significant(P<0.05).There were no difference before treatment in the scores of PEDI(self-care ability part)between the study group and control group(P>0.05).The PEDI(self-care ability section)score was significantly higher after 3 months of treatment than before treatment,the study group was(31±8)points,the control group was(27±7)points,and the score of study group was better than that of control group,the difference was statistically significant(P<0.05).In children,there were no difference before treatment in the score of GMFM-88 between the two groups(P>0.05).The GMFM-88 scores were significantly higher after 3 months of treatment than before treatment,the study group was(178±21)points,the control group was(169±17)points,and the score of study group was better than that of control group.The difference was statistically significant(P<0.05).There were no difference before treatment in the scores of PEDI(self-care ability part)between the two groups(P>0.05).The PEDI(self-care ability section)score was significantly higher after 3 months of treatment than before treatment,the study group was(41±8)points,the control group was(35±6)points,and the score of study group was better than that of control group,the difference was statistically significant(P<0.05).Conclusion The effect of conductive education combine with kinesiotherapy is better than that of kinesiotherapy alone,so it is worth of popularizing and applying further in clinic.