Department of Physical Therapy and Rehabilitation Science, University of Maryland, School of Medicine, Baltimore, Maryland 21201-1082, USA.
Physiother Theory Pract. 2010 Jan;26(1):56-61. doi: 10.3109/09593980802667771.
This case describes the outcomes of a multifaceted rehabilitation program including body weight-supported overground gait training (BWSOGT) in a nonambulatory child with cerebral palsy (CP) and the impact of this treatment on the child's functional mobility. The patient is a nonambulatory 10-year-old female with CP who during an inpatient rehabilitation stay participated in direct, physical therapy 6 days per week for 5 weeks. Physical therapy interventions included stretching of her bilateral lower extremities, transfer training, bed mobility training, balance training, kinesiotaping, supported standing in a prone stander, two trials of partial weight-supported treadmill training, and for 4 weeks, three to five times per week, engaged in 30 minutes of BWSOGT using the Up n' go gait trainer, Lite Gait Walkable, and Rifton Pacer gait trainer. Following the multifaceted rehabilitation program, the patient demonstrated increased step initiation, increased weight bearing through bilateral lower extremities, improved bed mobility, and increased participation in transfers. The child's Gross Motor Functional Measure (GMFM) scores increased across four dimensions and her Physical Abilities and Mobility Scale (PAMS) increased significantly. This case report illustrates that a multifaceted rehabilitation program including BWSOGT was an effective intervention strategy to improve functional mobility in this nonambulatory child with CP.
本病例描述了一个多方面康复计划的结果,包括在一名不能行走的脑瘫儿童中进行体重支持的地面步行训练(BWSOGT),以及这种治疗对儿童功能性移动能力的影响。患者是一名 10 岁的非行走脑瘫女性,在住院康复期间每周接受 6 天、每天 5 次的直接物理治疗,共持续 5 周。物理治疗干预包括双侧下肢伸展、转移训练、床移动训练、平衡训练、运动贴扎、在倾斜站立架中支撑站立、两次部分体重支撑跑步机训练,以及在接下来的 4 周内,每周进行 3 到 5 次,使用 Up n' go 步态训练器、Lite Gait Walkable 和 Rifton Pacer 步态训练器进行 30 分钟的 BWSOGT。在多方面的康复计划之后,患者表现出增加的步幅起始、双侧下肢承重增加、床移动能力改善和转移参与度增加。患儿的粗大运动功能测量(GMFM)评分在四个维度上均有所增加,其身体能力和移动量表(PAMS)也显著增加。本病例报告表明,包括 BWSOGT 的多方面康复计划是改善该非行走脑瘫儿童功能性移动能力的有效干预策略。