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家长参与下强化训练对纠正痉挛型双瘫患儿足尖步态效果的作用
作者:曹菲 
单位:南京医科大学附属南京儿童医院
关键词:家长参与:强化训练:痉挛型双瘫:功能障碍 
分类号:
出版年·卷·期(页码):2011·39·第六期(638-640)
摘要:

【目的】探讨指导家长参与强化训练对纠正痉挛型双瘫患儿尖足步态疗效的影响。【方法】将50例2~4岁痉挛型脑瘫且伴有尖足步态的患儿,按其家长是否自愿接受培训并参与强化运动治疗分为观察组和对照组。其中观察组27例,对照组23例。对照组只进行综合康复治疗。观察组在综合康复治疗的基础上实施家长参与的强化训练。综合康复治疗主要包括专业康复治疗师进行的PT治疗;肌痉挛,经络导平,脑循环等低频电疗;头针及推拿治疗。对家长的指导主要包括:指导家长具体康复治疗手技,纠正不规范动作;由责任护士督促家长进行PT治疗;记录训练中遇到的问题,由康复治疗师解答指导。3个月为一个疗程。治疗前、后采用盲法评定法,由不参加本研究的两名康复医师各自独立对患儿足背屈角被动活动范围,粗大运动功能量表(GMFM)的站立、行走功能项目进行评定[1]。【结果】治疗3个月后,观察组足背屈角被动活动度较对照组降低(P<0.05),GMFM站立评分及GMFM行走功能评分均较对照组增高(P<0.05);对照组和观察组治疗后的足背屈角被动活动度、GMFM站立及GMFM行走功能评分均较各组治疗前改善(P<0.05),差别有统计学意义。【结论】指导家长参与强化训练可更好的提高训练效果,是值得广泛推广的康复治疗模式。【关键词】家长参与 强化训练 痉挛型双瘫 功能障碍

Objective:To discuss the effect of intensive training by parents to the gait of children with spastic diplegia. Method:There were fifty children with spastic diplegia age from two to four years old. They were taken apart two groups. The observation group had 27 children, and the other 23 children were in the contrast group. Comprehensive rehabilitation include professional rehabilitation therapist for the PT treatment, low-frequency electrical stimulation, scalp acupuncture and massage therapy. Guidance for parents include that guiding rehabilitation therapy techniques, correcting the irregular action, urging parents to PT treatment and recording training problems. A course of treatment needs three months. I used blinding assessment method before and after treatment. The two doctors of rehabilitation independently assessed the angle of dorsiflexion with passive range of motion, standing and walking function in Gross Motor Function Measure (GMFM). They don’t participate in the study. Results:After 3 months of treatment, compared with the contrast group, the angle of dorsiflexion in observation group decreased(P<0.05) and scores of standing and walking in GMFM increased(P<0.05). After treatment, above all projects improved than the ones before treatment in two groups (P<0.05), the difference was statistically significant. Conclusion:Guiding parents to participate in intensive training make enhance the effect. It’s worthy of wide dissemination of therapy model. Key words: parental involvement, intensive training, spastic cerebral palsy, spastic diplegia, dysfunction

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