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一项比较脑瘫儿童使用多体位儿童手杖和三脚架原型与传统手杖和三脚架情况的试点研究。

A pilot study to compare the use of prototypes of multipositional paediatric walking sticks and tripods with conventional sticks and tripods by children with cerebral palsy.

作者信息

Toms B, Harrison B, Bower E

机构信息

Physiotherapy Department, Claremont School, Bristol, UK.

出版信息

Child Care Health Dev. 2007 Jan;33(1):96-106. doi: 10.1111/j.1365-2214.2006.00618.x.

Abstract

BACKGROUND

The researchers (B.H. and B.T.) designed prototypes of a walking stick and a tripod termed Multipositional Paediatric Walking Aids for children with cerebral palsy (CP). The design won the 'Jenx Award for Innovation in Paediatric Physiotherapy'. The object of this study was to ascertain whether the prototypes had any benefit over conventional designs in children with CP.

METHODS

A small case series within-subject comparison design was used. There were four periods, AABA, each 4 weeks in length. Prototypes were used during period B. Eight children with CP between 4 and 11 years were recruited, four used sticks and four used tripods. Following an orthopaedic assessment, each child had assessments at the commencement of the study and every 4 weeks thereafter: (1) Energy used while walking using Physiological Cost Index (PCI). (2) Motor abilities using (a) Gross Motor Function Measure (GMFM-88) and (b) Gross Motor Performance Measure (GMPM). (3) Hand/forearm position recorded on a visual analogue. (4) Parent/child questionnaire.

RESULTS

Physiological Cost Index improved overall when the prototypes were used suggesting the amount of energy used when walking with the prototypes was less than with conventional sticks/tripods. GMFM-88 and GMPM results improved for some but not all children. Results for PCI, GMFM and GMPM were not statistically significant. The hand/forearm position of stick users consistently improved at assessment 4. Questionnaire results indicated that stick users preferred the prototypes.

CONCLUSION

Multipositional sticks/tripods may have benefits over conventional sticks/tripods. Children using sticks rather than tripods preferred the prototypes. The study demonstrates the need to undertake scientifically controlled trials before marketing new equipment.

摘要

背景

研究人员(B.H. 和 B.T.)设计了一种手杖和一种三脚架的原型,称为多体位儿童助行器,用于脑瘫(CP)儿童。该设计获得了“珍克斯儿童物理治疗创新奖”。本研究的目的是确定这些原型在 CP 儿童中是否比传统设计有任何优势。

方法

采用小病例系列受试者内比较设计。有四个阶段,AABA,每个阶段时长 4 周。在阶段 B 使用原型。招募了 8 名 4 至 11 岁的 CP 儿童,4 名使用手杖,4 名使用三脚架。经过骨科评估后,每个儿童在研究开始时以及此后每 4 周进行一次评估:(1)使用生理成本指数(PCI)评估行走时消耗的能量。(2)使用(a)粗大运动功能测量(GMFM - 88)和(b)粗大运动表现测量(GMPM)评估运动能力。(3)在视觉模拟量表上记录手/前臂位置。(4)家长/儿童问卷。

结果

使用原型时,生理成本指数总体有所改善,表明使用原型行走时消耗的能量比使用传统手杖/三脚架时少。部分但并非所有儿童的 GMFM - 88 和 GMPM 结果有所改善。PCI、GMFM 和 GMPM 的结果无统计学意义。手杖使用者的手/前臂位置在第 4 次评估时持续改善。问卷结果表明,手杖使用者更喜欢原型。

结论

多体位手杖/三脚架可能比传统手杖/三脚架更具优势。使用手杖而非三脚架的儿童更喜欢原型。该研究表明在新设备上市前需要进行科学对照试验。

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