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家庭式助行跑台训练对脑瘫幼儿粗大运动功能的影响:一项准随机对照试验。

Effects of home-based locomotor treadmill training on gross motor function in young children with cerebral palsy: a quasi-randomized controlled trial.

机构信息

Department of Physical Therapy, California State University, Sacramento, CA.

出版信息

Arch Phys Med Rehabil. 2013 Nov;94(11):2061-7. doi: 10.1016/j.apmr.2013.05.012. Epub 2013 Jun 5.

Abstract

OBJECTIVE

To examine the effects of an intensive home-based program of treadmill training on motor skills related to walking in preambulatory children with cerebral palsy (CP).

DESIGN

Quasi-randomized controlled trial.

SETTING

Homes of the participants.

PARTICIPANTS

Children with CP (N=12) with Gross Motor Function Classification System levels I and II were assigned to the intervention group (n=6; mean age ± SD, 21.76±6.50mo) and control group (n=6; 21.25±6.07mo). All children were tested preintervention, postintervention, at a 1-month follow-up, and at a 4-month follow-up.

INTERVENTIONS

All children received their weekly scheduled physical therapy sessions at their homes. In addition, children in the intervention group walked on a portable treadmill in their homes 6 times per week, twice daily for 10- to 20-minute sessions, for 6 weeks. The intervention was carried out by the children's parents with weekly supervision by a physical therapist.

MAIN OUTCOME MEASURES

Gross Motor Function Measure-66 Dimensions D/E, Peabody Developmental Motor Scales-2 (PDMS-2), Pediatric Evaluation of Disability Inventory (PEDI), timed 10-m walk test (10MWT), and Functional Mobility Scale (FMS). The Friedman test and Mann-Whitney U test were conducted for within-group and between-group differences, respectively.

RESULTS

There was a significant between-group treatment effect for the PDMS-2 at posttest (P=.01) and 1-month postintervention follow-up (P=.09), as well as for the PEDI at posttest (P=.01), the 1-month postintervention follow-up (P=.009), and the 4-month postintervention follow-up (P=.04). The FMS was significant at the posttest (P=.04).

CONCLUSIONS

Home-based treadmill training accelerates the attainment of walking skills and decreases the amount of support used for walking in young children with CP.

摘要

目的

研究强化家庭跑步机训练方案对脑瘫(CP)前期儿童步行相关运动技能的影响。

设计

半随机对照试验。

地点

参与者家中。

参与者

CP 患儿(Gross Motor Function Classification System 水平 I 和 II),分为干预组(n=6;平均年龄±标准差,21.76±6.50 个月)和对照组(n=6;21.25±6.07 个月)。所有患儿在干预前、干预后、1 个月随访和 4 个月随访时进行测试。

干预措施

所有患儿均在其家中接受每周一次的物理治疗。此外,干预组患儿每周在家中使用便携式跑步机 6 次,每次 10-20 分钟,每天 2 次,持续 6 周。干预由患儿父母进行,每周由物理治疗师进行监督。

主要观察指标

粗大运动功能测量-66 项维度 D/E、Peabody 发育运动量表-2(PDMS-2)、小儿残疾评估量表(PEDI)、10m 走时测试(10MWT)和功能性移动量表(FMS)。采用 Friedman 检验和 Mann-Whitney U 检验分别进行组内和组间差异分析。

结果

PDMS-2 测试中,干预后即刻(P=.01)和干预后 1 个月随访(P=.09)、PEDI 测试中,干预后即刻(P=.01)、干预后 1 个月随访(P=.009)和干预后 4 个月随访(P=.04),以及 FMS 测试中,干预后即刻(P=.04)差异均具有统计学意义。

结论

家庭跑步机训练可加速脑瘫前期儿童步行技能的获得,并减少其步行时所需的支撑量。

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