动作观察疗法对脑性瘫痪患儿上肢功能作用的系统综述

Effect of action observation therapy on upper limb function in cerebral palsy:a systematic review

目的系统评价动作观察疗法(AOT)对脑瘫患儿上肢功能的作用。方法检索PubMed、Embase、Cochrane Library、Web of Science和中国知网等数据库,检索建库至2022年7月9日公开发表的AOT对脑瘫患儿上肢功能作用的相关文献,并进行系统综述。结果共纳入11篇文献,涉及497例患儿,发表时间集中于近10年,研究包括基于医院且有治疗师监督下开展的AOT和基于家庭且无治疗师监督下开展的AOT,主要评估对脑瘫患儿上肢功能的作用。试验组进行与日常生活活动相关的动作,对照组主要观看不包括动作的视频片段。每天15~120 min,每周3~5 d,干预周期大多为3~4周。AOT对于脑瘫患儿上肢功能的改善作用体现在身体结构与功能、活动和参与两个方面,体现为增加上肢握力、降低肌张力和提高手的灵活性和功能。结论基于医院且有治疗师监督下开展的AOT对于脑瘫患儿的上肢功能有改善作用。基于家庭且无治疗师监督下开展的AOT对于脑瘫患儿上肢功能的改善作用以及AOT的长期效应需要进一步研究。

Objective To systematically evaluate the effect of action observation therapy(AOT)on upper limb function in children with cerebral palsy.Methods Relevant literatures about the effect of AOT on upper limb function in children with cerebral palsy were retrieved from the databases of PubMed,Embase,Cochrane Library,Web of Science and CNKI,from the establishment to July 9,2022.Results Eleven articles involving 497 patients were included,which were mainly published in the past ten years.The studies included hospital-based studies with therapist supervision and home-based studies without therapist supervision,mainly related to the improvement of upper limb function of AOT in children with cerebral palsy.Experimental group performed actions related to activities of daily living,while control group mainly watched video clips excluding actions,15 to 120 minutes a time,three to five times a week,with most of the intervention periods of three to four weeks.AOT improved the upper limb function of children with cerebral palsy in terms of body structure and function,and activity and participation,specifically grip strength,muscle tension,and hand dexterity and function.Conclusion Hospital-based AOT with therapist supervision can improve upper limb function in children with cerebral palsy,while the effect of home-based AOT without therapist supervision and the long-term effect of AOT need to be further studied.