助行电刺激协同头针对痉挛型脑性瘫痪患儿行走功能及足底压力影响的对照研究

A comparative study on effects of portable functional electrical stimulator combined with scalp acupu ture on walking function and plantar pressure in children with spastic cerebral palsy

目的:观察助行功能性电刺激(functional electrical stimulator,FES)协同头针对痉挛型脑性瘫痪(脑瘫)患儿行走功能及足底压力的影响。方法:将40例痉挛型脑瘫患儿随机分为试验组(FES组联合头针)20例和对照组(头针组)20例。前者采用FES治疗协同头针和常规康复治疗,头针组给予头针和常规康复治疗。FES隔日治疗1次,每次20min,10次为1个小疗程,共治疗1个小疗程。采用10m步行速度、粗大运动功能测试(GMFM-88)、足底压力测试评价患儿治疗前后行走功能和足底压力的变化。结果:与治疗前相比,试验组患儿治疗后GMFM-88中的C评分、E评分和总分均有提高,10m步行速度增加,左右足底压力偏差减少,差异均有显著性意义(P<0.05);对照组治疗后患儿GMFM-88中的E评分和总分有提高,差异有显著性意义(P<0.05)。与对照组比较,治疗后试验组GMFM-88中的E评分和总分升高明显,10min步行速度增加显著,差异有显著性意义(P<0.05),两组治疗后左右脚足底压力偏差和身体重心移动范围差异无显著性意义。结论:肢体FES协同头针治疗有助于提升痉挛型脑瘫患儿的康复效果,改善行走功能和足底压力。

Objective:To observe the clinical effect of portable functional electrical stimulator(FES)combined with scalp acupuncture therapy on walking function and plantar pressure in children with spastic cerebral palsy.Method:Total 40 children with spastic cerebral palsy were divided into experimental group(FES combined with scalp acupuncture group)and control group(scalp acupuncture group),with 20 cases in each group.The former was treated with scalp acupuncture combined with FES and conventional rehabilitation treatment.The control group was given scalp acupuncture and conventional rehabilitation treatment.FES was treated once every other day,20 minutes each time,10 times for a small course of treatment,1 small course in total.10-meter walking speed,gross motor function test(GMFM-88)and plantar stress test scores were observed to evaluate the changes of walking function and plantar pressure before and after treatment.Result:After treatment,the C score,E score and total score of GMFM-88 in experimental group wereincreased,the 10-meter walking speed was increased,the deviation of left and right plantar pressure wasd ecreased,and the differences were statistically significant(P<0.05).After treatment,the E score and total score of GMFM-88 in the control groupp were also increased with statistically significant differences(P<0.05).Compared with the control group,the E score,the total score of GMFM-88 and 10min walking speed in the experimental group were significantly increased after treatment,and the difference was statistically significant(P<0.05).However,there was no statistically significant difference in the left and right foot plantar pressure deviation and body weight movement range between the two groups after treatment(P>0.05).Conclusion:The combination of limb FES and scalp acupuncture can improve the rehabilitation effect,walking function and plantar pressure in children with spastic hemiplegia to some extent.