渐进性抗阻训练治疗儿童青少年脑性瘫痪有效性的Meta分析

Meta-Analysis of the Effectiveness of Progressive Resistance Exercise in the Treatment of Cerebral Palsy in Children and Adolescents

目的:采用Meta分析系统评价渐进性抗阻训练(PRE)对脑性瘫痪(CP)儿童青少年运动功能的改善效果。方法:系统检索Medline、ERIC、CINAHL、SPORTDiscus、Embase、PsycINFO和Cochrane Library数据库相关文献,运用Review Manager软件进行分析。结果:共纳入8个随机对照实验,包括279名脑瘫患者。Meta分析结果显示:(1)股四头肌肌力、腘绳肌肌力、膝部伸肌肌力、自选速度行走、快速行走、6min行走能力和粗大运动功能,各研究之间均无异质性(I2=0.00%);(2)PRE组提高了CP儿童青少年的股四头肌肌力、腘绳肌肌力和膝部伸肌肌力,与实验前相比差异具有显著性,具有统计学意义,效应量分别为SMD=0.45(0.02,0.88)、SMD=0.53(0.10,0.96)和SMD=0.52(0.12,0.92);(3)PRE对于CP儿童青少年舒适走、快速走、6分钟走和粗大运动功能的提高不明显,差异不具有显著性,效应量分别为SMD=0.21(-0.17,0.59)、SMD=0.19(-0.31,0.68)、SMD=0.17(-0.31,0.64)和SMD=0.08(-0.32,0.48)。结论:(1)PRE干预可以显著增加CP儿童青少年下肢主要肌肉力量,包括股四头肌、腘绳肌和膝部伸肌;(2)PRE干预对CP儿童青少年的行走能力和粗大运动功能产生积极影响。

Objective: To evaluate the improvement effect of progressive resistance exercise(PRE) on motor function in children and adolescents with cerebral palsy(CP) by Meta-analysis system. Methods: Relevant literatures in Medline, ERIC, CINAHL, SPORTDiscus, Embase, PsycINFO and Cochrane Library were systematically searched and analyzed by Review Manager software.Results: A total of 8 randomized controlled trials were included, including 279 patients with cerebral palsy. The results of meta-analysis were showed as follows.(1) There was no heterogeneity among studies in quadriceps muscle strength, hamstring muscle strength, knee extensor muscle strength, walking at optional speed, fast walking, 6-minute walking ability and gross motor function(I~2=0.00%).(2) PRE improved the quadriceps muscle strength, hamstring muscle strength and knee extensor muscle strength of CP children and adolescents, the difference was significant and statistically significant, and the effect sizes were SMD=0.45(0.02,0.88), SMD=0.53(0.10,0.96) and SMD=0.52(0.12,0.92), respectively.(3) PRE was not obvious for the improvement of comfortable walking, fast walking, 6-minute walking and gross motor function of CP children and adolescents,and the difference was not significant. The effect sizes were SMD=0.21(-0.17, 0.59), SMD=0.19(-0.31,0.68),SMD=0.17(-0.31, 0.64) and SMD=0.08(-0.32, 0.48), respectively. Conclusions 1) PRE intervention can significantly increase the lower limb muscle strength of CP children and adolescents, including quadriceps femoris muscle, hamstring muscle and knee extensor muscle.(2) PRE intervention had a positive impact on walking ability and gross motor function of CP children and adolescents.To evaluate the improvement effect of progressive resistance exercise(PRE) on motor function in children and adolescents with cerebral palsy(CP) by Meta-analysis system.