Damiano Diane L, Alter Katharine E, Chambers Henry
Functional & Applied Biomechanics Section, Clinical Center, National Institutes of Health, 10 Center Drive, Bethesda, MD 20892, USA.
Phys Med Rehabil Clin N Am. 2009 Aug;20(3):469-91. doi: 10.1016/j.pmr.2009.04.005.
Cerebral palsy (CP) is the most prevalent physical disability in childhood and includes a group of disorders with varying manifestations. This article focuses on current and future intervention strategies for improving mobility and participation during the lifespan for ambulatory children with CP. The provision and integration of physical therapy and medical and orthopedic surgery management focused primarily on the lower extremities are discussed here. Some of the newer trends are more intense and task-related exercise strategies, greater precision in tone identification and management, and a shift towards musculoskeletal surgery that focuses more on promoting dynamic bony alignment and less on releasing or lengthening tendons. Advances in basic and clinical science and technology development are changing existing paradigms and offering renewed hope for improved functioning for children with CP who face a lifelong disability with unique challenges at each stage in life.
脑性瘫痪(CP)是儿童期最常见的身体残疾,包括一组表现各异的病症。本文重点关注改善能行走的CP儿童在其一生中的活动能力和参与度的当前及未来干预策略。这里讨论了主要针对下肢的物理治疗以及医学和矫形外科管理的提供与整合。一些新趋势包括更强化且与任务相关的运动策略、在肌张力识别和管理方面更高的精准度,以及向更侧重于促进动态骨对线而非肌腱松解或延长的肌肉骨骼手术的转变。基础科学和临床科学以及技术发展的进步正在改变现有的模式,并为面临终身残疾且在人生每个阶段都有独特挑战的CP儿童改善功能带来新的希望。