1~6岁痉挛型偏瘫儿童强制性诱导运动疗法剂量与疗效分析

Dosage and Efficacy Analysis of Constraint Induced Movement Therapy for Children with Spastic Hemiplegia Aged 1 to 6 Years

目的观察1~6岁痉挛型偏瘫儿童强制性诱导运动疗法(constraint induced movement therapy,CIMT)剂量与疗效,探讨有效提高偏瘫侧肢体运动功能以及不影响非偏瘫侧运动功能发育的最合适剂量。方法选取60例痉挛型偏瘫儿童作为研究对象,采用随机数字表法分为对照组和观察组,各30例。观察组常规康复+CIMT治疗,每日4 h,每周5 d,连续3个月,对照组常规康复+CIMT治疗,每日6 h,每周5 d,连续3个月。比较2组患者干预前、干预30 d、干预90 d非偏瘫侧Peabody运动发育量表评分,偏瘫侧Peabody运动发育量表以及Carroll手功能试验评分。结果2组偏瘫侧粗大运动商、精细运动商、总运动商评分随时间呈上升趋势,且观察组偏瘫侧粗大运动商、精细运动商、总运动商评分高于对照组,差异有统计学意义(P<0.05)。2组偏瘫侧Carroll手功能试验评分随时间呈上升趋势,且观察组偏瘫侧Carroll手功能试验评分高于对照组,差异有统计学意义(P<0.05)。结论CIMT运用在1~6岁痉挛型偏瘫儿童中可有效提高偏瘫侧运动功能,不影响非偏瘫侧肢体运动功能发育的最合适剂量可能是4 h。

Objective To study the dose and efficacy of constraint induced movement therapy(CIMT)for children with spastic hemiplegia aged 1 to 6 years,to find out the most suitable dose that can effectively improve the motor function of the hemiplegic side without affecting the development of the motor function of the non-hemiplegic side.Methods A total of 60 children with spastic hemiplegia were selected as the research objects and divided into the control group and the observation group by random number table method,30 cases in each group.The observation group was given routine rehabilitation combined with CIMT at a dose of 4 hours a day,5 days a week for 3 consecutive months,while the control group was treated with routine rehabilitation combined with CIMT at a dose of 6 hours a day,5 days a week for 3 consecutive months.The scores of Peabody Motor Development Scale on the non-hemiplegic side and the hemiplegic side,and Carroll hand function test scores were compared between the two groups before intervention and on the 30th day and the 90th day after the intervention.Results The gross motor quotient,fine motor quotient and total motor quotient of the hemiplegic side in the two groups increased with time,and the above indicators in observation group were higher than those in the control group,the differences were statistically significant(P<0.05).The scores of Carroll hand function test on the hemiplegic side in the two groups showed an upward trend with time,and the scores in the observation group were higher than those in the control group,the difference were statistically significant(P<0.05).Conclusion CIMT can effectively improve the motor function of the hemiplegic side in children aged 1 to 6 years with spastic hemiplegia,and the most suitable dose may be 4 hours without affecting the development of the motor function of the non-hemiplegic side.