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约翰斯通压力夹板联合神经发育疗法对痉挛型脑瘫患儿痉挛状态及皮肤感觉输入的影响

Effects of Johnstone pressure splints combined with neurodevelopmental therapy on spasticity and cutaneous sensory inputs in spastic cerebral palsy.

作者信息

Kerem M, Livanelioglu A, Topcu M

机构信息

School of Physical Therapy and Rehabilitation, Department of Cerebral Palsy and Paediatric Rehabilitation, Hacettepe University, Ankara, Turkey.

出版信息

Dev Med Child Neurol. 2001 May;43(5):307-13. doi: 10.1017/s0012162201000585.

Abstract

The purpose of this study was to investigate the effectiveness of Johnstone pressure splints (JPSs) on spasticity and cutaneous sensory inputs in children with spastic cerebral palsy (CP). Thirty-four children with spastic diplegic CP participated in this study. Children whose motor development levels were similar were divided into a treatment and a control group. Each group consisted of 17 participants (six females and 11 males). Mean age of the treatment group was 48.82 months (SEM 4.42), and the control group, 47.52 months (SEM 5.27). The treatment group underwent Bobath's neurodevelopmental therapy (NDT) combined with JPSs. The control group underwent NDT alone five days a week for three months. Before and after treatments, lower-extremity passive range of motion (ROM) by goniometric measurements, spasticity by Modified Ashworth Scale (MAS), and somatosensory evoked potentials (SEPs) were measured. Passive ROM showed significant improvements in both groups (p<0.01). In the treatment group, all MAS scores increased. In the control group, the difference was significant except for values of internal rotator muscles. Improvements in passive ROM in the treatment group were significantly higher than the control group except in hip abduction and external rotation (p<0.05). MAS scores of the treatment group were significantly higher than the control group (p<0.05). SEP values increased in both groups but values of the treatment group were significantly higher than the control group (p<0.05).

摘要

本研究的目的是调查约翰斯通压力夹板(JPSs)对痉挛型脑瘫(CP)患儿痉挛和皮肤感觉输入的有效性。34名痉挛型双瘫CP患儿参与了本研究。将运动发育水平相似的儿童分为治疗组和对照组。每组由17名参与者组成(6名女性和11名男性)。治疗组的平均年龄为48.82个月(标准误4.42),对照组为47.52个月(标准误5.27)。治疗组接受鲍巴斯神经发育疗法(NDT)并结合JPSs。对照组每周五天单独接受NDT,为期三个月。在治疗前后,通过量角器测量下肢被动活动范围(ROM),采用改良Ashworth量表(MAS)评估痉挛程度,并测量体感诱发电位(SEPs)。两组的被动ROM均有显著改善(p<0.01)。治疗组中,所有MAS评分均升高。对照组中,除内旋肌的值外,差异具有显著性。治疗组被动ROM的改善除髋关节外展和外旋外,均显著高于对照组(p<0.05)。治疗组的MAS评分显著高于对照组(p<0.05)。两组的SEP值均升高,但治疗组的值显著高于对照组(p<0.05)。

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