Gibson Susan K, Sprod Judy A, Maher Carol A
Physical Rehabilitation, Novita Children's Services, South Australia, Australia.
Int J Rehabil Res. 2009 Dec;32(4):316-23. doi: 10.1097/MRR.0b013e32831e4501.
The objective of this study was to determine whether static weight-bearing in a standing frame affected hamstring length and ease of activities of daily living (ADLs) in nonambulant children with cerebral palsy (CP). A convenient sample of nonambulant children with CP was recruited for this one-group quasi-experimental study. Participants stood in a standing frame for 1 h, 5 days per week, for 6 weeks, followed by 6 weeks of not using a standing frame; each phase was repeated. Popliteal angle measurements were made at baseline and weekly throughout the study period. Carers provided written feedback regarding ease of ADLs at the end of each standing and nonstanding phase. Five children were recruited (age range 6-9 years, mean age 7 years 2 months, SD 1 year 4 months). High compliance with the standing regime was achieved (85% of intended sessions completed). Repeated-measures analysis of variance and t-tests showed hamstrings significantly lengthened during standing phases (mean improvement 18.1 degrees , SD 5.5, P<0.01 for first standing phase; mean improvement 12.1 degrees , SD 7.7, P=0.03 for second standing phase). A trend for hamstrings to shorten during nonstanding phases was observed (mean change -14.0 degrees , SD 4.2, P=0.02 for first nonstanding phase; mean change -7.3 degrees , SD 6.5, P=0.20 for second nonstanding phase). Feedback from carers suggested that transfers and ADLs became slightly easier after phases of standing frame use. Preliminary evidence that 6 weeks of standing frame use leads to significant improvements in hamstring length in nonambulant children with CP, and may increase ease of performance of ADLs was found.
本研究的目的是确定站立架中的静态负重是否会影响非行走型脑瘫（CP）患儿的腘绳肌长度及日常生活活动（ADL）的便利性。本研究为单组准实验研究，招募了便利样本的非行走型CP患儿。参与者每周5天，每天在站立架中站立1小时，共6周，随后6周不使用站立架；每个阶段重复进行。在整个研究期间，于基线时及每周测量腘绳肌角。护理人员在每个站立和非站立阶段结束时提供关于ADL便利性的书面反馈。招募了5名儿童（年龄范围6 - 9岁，平均年龄7岁2个月，标准差1岁4个月）。站立方案的依从性较高（完成了85%的预定疗程）。重复测量方差分析和t检验显示，在站立阶段腘绳肌显著延长（第一个站立阶段平均改善18.1度，标准差5.5，P<0.01；第二个站立阶段平均改善12.1度，标准差7.7，P = 0.03）。观察到在非站立阶段腘绳肌有缩短的趋势（第一个非站立阶段平均变化 - 14.0度，标准差4.2，P = 0.02；第二个非站立阶段平均变化 - 7.3度，标准差6.5，P = 0.20）。护理人员的反馈表明，在使用站立架阶段后，转移和ADL变得稍微容易一些。有初步证据表明，6周的站立架使用可使非行走型CP患儿的腘绳肌长度得到显著改善，并可能提高ADL的执行便利性。
