水下步态训练对脑瘫患儿行走和平衡能力的影响分析

Analysis of the influence of underwater gait training on walking and balance ability of children with cerebral palsy

目的:评估水疗对脑瘫患儿行走及平衡能力的影响.方法:选取本院2021年至2023年期间收治的58名脑瘫患儿作为研究对象,随机分为对照组和观察组,每组各29例.对照组采取步行康复训练,观察组采用水下步态训练.采用20米步行实验比较两组8 w后的步态参数;关节角度尺检测下肢关节活动度;三维测力平台检测静态平衡能力.结果:训练8 w后,两组的步伐距离、步伐速度均比训练前显著提升,步伐宽度均比训练前显著降低(P<0.05);观察组的步伐距离、步伐速度均比对照组显著提升,步伐宽度比对照组显著降低(P<0.05).训练后,两组的足背屈角度腘窝角度均比训练前显著提升,足背屈角度均比训练前显著降低(P<0.05);且观察组的足背屈角度腘窝角度比对照组显著提升,足背屈角度比对照组显著降低(P<0.05).训练后,两组的压力中心移动轨迹长度(Lng),90%压力中心移动轨迹椭圆面积(Area),X轴方向最大移动距离(DeltaX),Y轴方向最大移动距离(DeltaY),单位面积轨迹长(Lng/A)均比训练前显著降低(P<0.05);且观察组的Lng、Area、DeltaX、DeltaY、Lng/A均比对照组显著降低(P<0.05).结论:水疗对于脑瘫患儿的行走及平衡能力康复效果高于普通步行训练,有助于提高患儿康复.

Objective:To evaluate the effects of hydrotherapy on walking and balance in children with cerebral palsy.Methods:Fifty-eight children with cerebral palsy admitted to our hospital from 2021 to 2023 were selected as research objects and randomly divided into control group and observation group,with 29 cases in each group.The control group received walking rehabilitation training,and the observation group received underwater gait training.The 20 meter walking experiment was used to compare the gait parameters of the two groups after 8 weeks.Joint Angle scale was used to measure the lower limb joint motion.Three-dimensional force measuring platform to detect static balance ability.Results:After 8 weeks of training,the step distance and step speed of both groups were significantly increased,and the step width was significantly decreased(P<0.05).Compared with the control group,the step distance and step speed of the observation group were significantly increased,and the step width was significantly decreased(P<0.05).After training,the foot dorsiflexion Angle of popliteal fossa in both groups was significantly higher than before training,and the foot dorsiflexion Angle was significantly lower than before training(P<0.05).The Angle of foot dorsiflexion in the observation group was significantly higher than that in the control group,and the Angle of foot dorsiflexion was significantly lower than that in the control group(P<0.05).After training,the length of pressure center moving path(Lng),the ellipse Area(Area)of 90%of the pressure center moving path,the maximum moving distance in the X axis direction(DeltaX),the maximum moving distance in the Y axis direction(DeltaY),and the track length per unit area(Lng/A)of the two groups were significantly reduced compared with those before training(P<0.05).The levels of Lng,Area,DeltaX,DeltaY and Lng/A in the observation group were significantly lower than those in the control group(P<0.05).Conclusion:Hydrotherapy can improve the rehabilitation of walking and balance ability of children with cerebral palsy,which is better than ordinary walking training.