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目的观察肌痉挛治疗仪在痉挛型双瘫患儿康复治疗中的作用。方法将22例(年龄2~4岁)痉挛型双瘫患儿随机分为治疗组和对照组,每组各11例。治疗组在采用常规康复治疗的同时加用肌痉挛治疗仪治疗30 d,每次15 m in,每天1次;对照组仅进行30 d的常规康复训练,分别在疗程开始与结束时采用改良的Ashworth量表(改良的Ashworth分值,MAS)测定患儿腘绳肌肌张力变化及腘窝角的被动关节活动度(PROM)变化,并采用粗大运动功能量表88项(GMFM-88)中的D和E二项、综合痉挛量表(CSS)进行评定。结果治疗前2组患儿肌张力变化、腘窝角PROM变化、GMFM-88(D、E功能区)及CSS评分比较,差异均无统计学意义(Pa>0.05)。治疗30 d后,治疗组与对照组MAS量化评分及CSS评分下降,而腘窝角角度有所增加,GMFM-88中的站立、走跑跳两大功能区评分提高,与各自治疗前比较,差异均有统计学意义(Pa<0.05)。结论肌痉挛治疗仪能有效降低痉挛型双瘫患儿的腘绳肌肌张力及下肢痉挛程度,并改善步态,提高运动能力。
Objective To observe the effect of muscle spasms therapeutic apparatus on the rehabilitation of children with spastic diplexy. Methods Twenty-two children (aged 2 to 4 years old) with spastic diplegia were randomly divided into treatment group and control group, with 11 cases in each group. The patients in the treatment group were treated with the conventional treatment of muscle spasm for 30 days for 15 m in each. The control group was given only 30 days of conventional rehabilitation training. At the beginning and the end of the treatment, Ashworth scale (modified Ashworth score, MAS) was used to measure changes of hamstring muscle tone and popliteal angle of passive joint activity (PROM) in children. The gross motor function scale (GMFM-88) Of the D and E two items, the Comprehensive Spasm Scale (CSS) were assessed. Results There were no significant differences in the changes of muscle tension, popliteal horn PROM, GMFM-88 (D, E functional area) and CSS scores between the two groups before treatment (P> 0.05). After 30 days of treatment, the scores of MAS and CSS in treatment group and control group decreased, while the angle of pterygium was increased. The scores of standing and walking in GMFM-88 increased, compared with those before treatment, The differences were statistically significant (Pa <0.05). Conclusion Muscle spasm therapeutic apparatus can effectively reduce the hamstring muscle tension and lower extremity spasticity in children with spastic diplegia, and improve gait and improve motor ability.