悬吊训练联合重复经颅磁刺激治疗对痉挛型脑瘫儿童的疗效观察

Therapeutic effect of suspension training combined with repetitive transcranial magnetic stimulation on children with spastic cerebral palsy

目的:观察悬吊训练(sling exercise training,SET)联合重复经颅磁刺激对痉挛型脑瘫(以下简称脑瘫)儿童的临床疗效。方法:选取淮安市妇幼保健院儿童康复科门诊、住院部符合纳入及排除标准的48例脑瘫患儿,随机分为常规组、悬吊组、联合组3组,每组各16例。常规组进行常规康复训练,悬吊组在常规康复训练基础上予以悬吊训练,联合组在悬吊组基础上进行重复性经颅磁刺激治疗。观察3组患儿治疗前后在粗大运动功能测试量表(GMFM-88)站立D区及走、跑跳E区评分及Berg平衡量表(BBS)、日常生活活动能力(ADL)评分变化情况。结果:与治疗前相比,3组患儿在GMFM-88 D区、GMFM-88 E区、BBS、ADL评分上均有显著改善(P<0.05)。联合组在改善患儿GMFM-88 D区、GMFM-88 E区、BBS、ADL评分上均优于常规组(P<0.05);悬吊组在改善患儿GMFM-88 D区、GMFM-88 E区、BBS评分上优于常规组(P<0.05),在改善ADL评分上有所提高,差异无统计学意义(P>0.05);联合组在改善患儿GMFM-88 D区、GMFM-88 E区、BBS评分上优于悬吊组(P<0.05),在改善ADL评分上有所提高,但差异无统计学意义(P>0.05)。结论:悬吊训练联合rTMS可显著改善脑瘫患儿平衡、站立、行走等粗大运动功能,有效提高患儿在日常生活活动中的自主性和独立性。

Objective:To observe the clinical effect of suspension training combined with repetitive transcranial magnetism on spastic cerebral palsy children.Methods:48 children with cerebral palsy who met the inclusion and exclusion criteria in the outpatient and inpatient department of the Child Rehabilitation Department of Huai'an Maternal and Child Health Hospital were randomly divided into routine group,suspension group and combined group,with 16 cases in each group.The conventional group received routine rehabilitation training,the suspension group received suspension training on the basis of routine rehabilitation training,and the combined group received repetitive transcranial magnetism treatment on the basis of suspension group.The scores of standing D area,walking,running and jumping E area,Berg balance scale and activity of daily living(ADL)of the three groups were observed before and after treatment.Results:Compared with before treatment,the scores of GMFM-88D area,GMFM-88E area,BBS and ADL in three groups were significantly improved(P<0.05).In the combined group,GMFM-88D area and GMFM-88 were improved.The scores of E-zone,BBS and ADL were better than those of conventional group(P<0.05).In the suspension group,GMFM-88D area and GMFM-88 were improved.E-zone and BBS scores were better than those of the conventional group(P<0.05),and ADL scores were improved,but the difference was not statistically significant(P>0.05).In the combined group,GMFM-88D area and GMFM-88 were improved.The scores of E-zone and BBS were better than those of suspension group(P<0.05),and the scores of ADL were improved,but the difference was not statistically significant(P>0.05).Conclusion:Suspension training combined with rTMS can significantly improve the balance,standing,walking and other gross motor functions in children with cerebral palsy,and effectively improve their autonomy and independence in activities of daily living.