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经皮神经电刺激髋关节内收肌可改善痉挛型双瘫脑瘫患儿的步态参数。

Transcutaneous electrical nerve stimulation of hip adductors improves gait parameters of children with spastic diplegic cerebral palsy.

机构信息

Rehabilitation Sciences Department, Faculty of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.

出版信息

NeuroRehabilitation. 2010;26(2):115-22. doi: 10.3233/NRE-2010-0542.

Abstract

BACKGROUND

Reduction of spasticity in hip adductor muscles is one of the essential factors to improve standing, gait, and personal hygiene of children with spastic diplegic cerebral palsy (CP). Surgical and medical methods have been commonly used for such purposes. These methods are expensive, required special skill and have side effects.

OBJECTIVE

To study the effect of conventional TENS on spasticity in hip adductors and gait parameters of children with spastic diplegic CP.

SUBJECT

An experimental group of twenty seven ambulant children with spastic diplegic CP and control group of fifteen healthy children were voluntary participants in the study.

METHODS

The experimental group received two different TENS management programs. The 1st TENS program was a one-time trial management program that included an ongoing application of conventional TENS on bilateral hip adductors during passive hip abduction, and during walking for a pre-determined distance. The 2nd TENS program was a one-week trial management program that included 15 minutes of ongoing application of conventional TENS on bilateral hip adductors during walking, three sessions a day for a week. The effects of the TENS program was assessed using the Modified Ashworth Scale, the balance master system and visual observations of knee positions.

RESULTS

A significant improvement was recorded in spasticity of hip adductors, gait parameters and knees position of the experimental group.

CONCLUSION

Functional application of TENS to hip adductors of children with spastic diplegic CP can reduce spasticity and improve gait pattern.

摘要

背景

降低髋内收肌痉挛是改善痉挛性双瘫脑瘫患儿站立、步态和个人卫生的重要因素之一。为此,通常采用手术和医学方法。这些方法费用昂贵,需要特殊技能,且有副作用。

目的

研究常规经皮神经电刺激(TENS)对痉挛性双瘫脑瘫患儿髋内收肌痉挛和步态参数的影响。

受试者

27 名可自主移动的痉挛性双瘫脑瘫患儿为实验组,15 名健康儿童为对照组,自愿参加本研究。

方法

实验组接受两种不同的 TENS 管理方案。第 1 个 TENS 方案为一次性试验管理方案,包括在被动髋关节外展和预定距离行走过程中持续应用常规 TENS 双侧髋内收肌;第 2 个 TENS 方案为为期一周的试验管理方案,包括在行走时持续应用常规 TENS 双侧髋内收肌 15 分钟,每天 3 次,持续一周。通过改良 Ashworth 量表、平衡大师系统和膝关节位置的视觉观察评估 TENS 方案的效果。

结果

实验组髋内收肌痉挛、步态参数和膝关节位置均有显著改善。

结论

功能性 TENS 应用于痉挛性双瘫脑瘫患儿髋内收肌可降低痉挛程度,改善步态模式。

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