全身振動訓(xùn)練對1～3歲痙攣型腦癱兒童下肢運(yùn)動功能的影響
發(fā)布時(shí)間：2018-10-08 14:03
【摘要】：目的:觀察全身振動(Whole body vibration,WBV)訓(xùn)練對1~3歲痙攣型腦癱兒童下肢痙攣狀態(tài)、粗大運(yùn)動功能、平衡功能的影響及不良反應(yīng)。方法:1、病例選擇:選取鄭州大學(xué)第三附屬醫(yī)院兒童康復(fù)科2015年11月~2016年11月期間住院的1~3歲痙攣型腦癱患兒共184例,隨機(jī)分為常規(guī)訓(xùn)練組和全身振動訓(xùn)練組,完成24周康復(fù)治療和隨訪的患兒共150例,包括常規(guī)訓(xùn)練組75例(n=75)和全身振動訓(xùn)練組75例(n=75)。2、治療方法:常規(guī)訓(xùn)練組給予24周的運(yùn)動療法、石蠟療法及神經(jīng)肌肉電刺激療法;全身振動訓(xùn)練組在常規(guī)訓(xùn)練的基礎(chǔ)上給予24周的全身振動訓(xùn)練。3、療效評定:在治療前、治療12周、治療24周,采用改良Tardieu量表(Modified Tardieu Scale,MTS)、表面肌電圖(surface electromyograms,sEMG)被動狀態(tài)數(shù)值對患兒下肢痙攣程度進(jìn)行評價(jià),采用粗大運(yùn)動功能測試量表-88(Gross Motor Function Measure,GMFM-88)、Berg平衡量表(Berg Balance Scale,BBS)對患兒粗大運(yùn)動功能及平衡功能進(jìn)行評價(jià)。4、不良反應(yīng)的觀察:全身振動訓(xùn)練期間及訓(xùn)練后,觀察患兒有無哭鬧、不適、眩暈、下肢紅腫等不良反應(yīng),并做記錄。結(jié)果:1、基線比較:治療前兩組患兒性別、月齡、GMFCS分級、MTS評分、MTS踝關(guān)節(jié)角度R1、R2、sEMG被動狀態(tài)數(shù)值、GMFM-88評分、BBS評分無明顯差異(P0.05);2、痙攣程度:兩組患兒MTS評分、MTS踝關(guān)節(jié)角度R1、R2、sEMG被動狀態(tài)數(shù)值在治療12周、治療24周均顯著優(yōu)于治療前(P0.05)。全身振動訓(xùn)練組乆繩肌與踝跖屈肌的MTS評分和sEMG被動狀態(tài)數(shù)值、MTS踝關(guān)節(jié)角度R1、R2在各時(shí)間點(diǎn)均顯著優(yōu)于常規(guī)訓(xùn)練組(P0.05)。而內(nèi)收肌的MTS分級評分和sEMG被動狀態(tài)數(shù)值在各時(shí)間點(diǎn)與常規(guī)訓(xùn)練組無顯著差異(P0.05)。3、粗大運(yùn)動功能及平衡功能兩組患兒GMFM-88、BBS評分在治療12周、治療24周均顯著優(yōu)于治療前(P0.05)。全身振動訓(xùn)練組BBS評分在各時(shí)間點(diǎn)均顯著優(yōu)于常規(guī)訓(xùn)練組(P0.05)。GMFM-88評分在治療12周與常規(guī)訓(xùn)練組無顯著差異(P0.05),在治療24周顯著優(yōu)于常規(guī)訓(xùn)練組(P0.05)。4、不良反應(yīng)全身振動訓(xùn)練期間及訓(xùn)練后個別患兒出現(xiàn)短暫哭鬧,但在患兒家長安撫下迅速停止。所有患兒均未出現(xiàn)不適感、眩暈、下肢紅腫等不良反應(yīng)。結(jié)論:1、與常規(guī)康復(fù)訓(xùn)練相比,全身振動訓(xùn)練結(jié)合常規(guī)康復(fù)訓(xùn)練能更好的提高1~3歲痙攣型腦癱兒童的粗大運(yùn)動功能和平衡功能,緩解其乆繩肌與踝跖屈肌的痙攣程度。2、全身振動訓(xùn)練應(yīng)用于1~3歲痙攣型腦癱兒童安全可靠,未發(fā)現(xiàn)相關(guān)不良反應(yīng)。
[Abstract]:Objective: to observe the effects and side effects of whole body vibration (Whole body vibration,WBV training on lower extremity spasticity, coarse motor function and balance function in children with spastic cerebral palsy aged 1 to 3 years. Methods: a total of 184 children with spastic cerebral palsy aged from November 2015 to November 2016 were randomly divided into routine training group and whole body vibration training group in the Department of Children's Rehabilitation, third affiliated Hospital of Zhengzhou University, from November 2015 to November 2016, in which 184 children with spastic cerebral palsy were randomly divided into two groups: routine training group and general vibration training group. A total of 150 children completed 24 weeks rehabilitation and follow-up, including 75 patients in routine training group and 75 patients in whole body vibration training group. The treatment methods: routine training group received 24 weeks exercise therapy, paraffin wax therapy and neuromuscular electrical stimulation therapy. The whole body vibration training group was given 24 weeks whole body vibration training on the basis of routine training. The curative effect was evaluated: before treatment, 12 weeks treatment, 24 weeks treatment, The degree of lower extremity spasm in children was evaluated by modified Tardieu scale (Modified Tardieu Scale,MTS) and surface electromyography (surface electromyograms,sEMG) passive state. Gross motor function test scale (-88 (Gross Motor Function Measure,GMFM-88) and Berg balance scale (Berg Balance Scale,BBS) were used to evaluate the gross motor function and balance function of children. The adverse reactions were observed: during and after the whole body vibration training, the children were observed whether they were crying or not. Adverse reactions, such as vertigo, redness and swelling of the lower extremities, were recorded. Results: 1. Baseline comparison: sex of the two groups before treatment, There was no significant difference in the passive state of the MTS ankle angle between the two groups (P0.05). Spasticity degree: the MTS score of the two groups and the passive state of the MTS ankle angle R1 / R2SEMG were significantly higher than those before the treatment at 12 weeks and 24 weeks (P0.05). The MTS score and sEMG passive state value of the whole body vibration training group were significantly better than that of the conventional training group at each time point (P0.05). However, there was no significant difference in MTS grading and sEMG passive state between adductor muscle and routine training group at each time point (P0.05). The GMFM-88,BBS score of coarse motor function and balance function in the two groups was significantly better than that before treatment at 12 weeks and 24 weeks (P0.05). The BBS score of the whole body vibration training group was significantly better than that of the conventional training group at each time point (P0.05). GMFM-88 score had no significant difference between the conventional training group and the conventional training group at 12 weeks (P0.05), but at the 24th week of treatment, it was significantly better than the conventional training group (P0.05). During and after training, some of the children appeared to cry for a short time. But in the child's parents under the comfort of the rapid cessation. No adverse reactions such as discomfort, dizziness, redness of lower extremities were found in all children. Conclusion compared with conventional rehabilitation training, the whole body vibration training combined with conventional rehabilitation training can improve the motor function and balance function of children with spastic cerebral palsy of 1 or 3 years old. It was safe and reliable to use the whole body vibration training in children with spastic cerebral palsy of 1 to 3 years old, and no related adverse reactions were found.
【學(xué)位授予單位】：鄭州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R742.3
本文編號：2257031
[Abstract]:Objective: to observe the effects and side effects of whole body vibration (Whole body vibration,WBV training on lower extremity spasticity, coarse motor function and balance function in children with spastic cerebral palsy aged 1 to 3 years. Methods: a total of 184 children with spastic cerebral palsy aged from November 2015 to November 2016 were randomly divided into routine training group and whole body vibration training group in the Department of Children's Rehabilitation, third affiliated Hospital of Zhengzhou University, from November 2015 to November 2016, in which 184 children with spastic cerebral palsy were randomly divided into two groups: routine training group and general vibration training group. A total of 150 children completed 24 weeks rehabilitation and follow-up, including 75 patients in routine training group and 75 patients in whole body vibration training group. The treatment methods: routine training group received 24 weeks exercise therapy, paraffin wax therapy and neuromuscular electrical stimulation therapy. The whole body vibration training group was given 24 weeks whole body vibration training on the basis of routine training. The curative effect was evaluated: before treatment, 12 weeks treatment, 24 weeks treatment, The degree of lower extremity spasm in children was evaluated by modified Tardieu scale (Modified Tardieu Scale,MTS) and surface electromyography (surface electromyograms,sEMG) passive state. Gross motor function test scale (-88 (Gross Motor Function Measure,GMFM-88) and Berg balance scale (Berg Balance Scale,BBS) were used to evaluate the gross motor function and balance function of children. The adverse reactions were observed: during and after the whole body vibration training, the children were observed whether they were crying or not. Adverse reactions, such as vertigo, redness and swelling of the lower extremities, were recorded. Results: 1. Baseline comparison: sex of the two groups before treatment, There was no significant difference in the passive state of the MTS ankle angle between the two groups (P0.05). Spasticity degree: the MTS score of the two groups and the passive state of the MTS ankle angle R1 / R2SEMG were significantly higher than those before the treatment at 12 weeks and 24 weeks (P0.05). The MTS score and sEMG passive state value of the whole body vibration training group were significantly better than that of the conventional training group at each time point (P0.05). However, there was no significant difference in MTS grading and sEMG passive state between adductor muscle and routine training group at each time point (P0.05). The GMFM-88,BBS score of coarse motor function and balance function in the two groups was significantly better than that before treatment at 12 weeks and 24 weeks (P0.05). The BBS score of the whole body vibration training group was significantly better than that of the conventional training group at each time point (P0.05). GMFM-88 score had no significant difference between the conventional training group and the conventional training group at 12 weeks (P0.05), but at the 24th week of treatment, it was significantly better than the conventional training group (P0.05). During and after training, some of the children appeared to cry for a short time. But in the child's parents under the comfort of the rapid cessation. No adverse reactions such as discomfort, dizziness, redness of lower extremities were found in all children. Conclusion compared with conventional rehabilitation training, the whole body vibration training combined with conventional rehabilitation training can improve the motor function and balance function of children with spastic cerebral palsy of 1 or 3 years old. It was safe and reliable to use the whole body vibration training in children with spastic cerebral palsy of 1 to 3 years old, and no related adverse reactions were found.
【學(xué)位授予單位】：鄭州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R742.3
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