Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada.
Semin Pediatr Neurol. 2013 Jun;20(2):106-15. doi: 10.1016/j.spen.2013.06.011.
The objective of this paper is to (1) identify from the literature a potential critical period for the maturation of the corticospinal tract (CST) and (2) report pilot data on an intensive, activity-based therapy applied during this period, in children with lesions to the CST. The best estimate of the CST critical period for the legs is when the child is younger than 2 years of age. Previous interventions for walking in children with CST damage were mainly applied after this age. Our preliminary results with training children younger than 2 years showed improvements in walking that exceeded all previous reports. Further, we refined techniques for measuring motor and sensory pathways to and from the legs, so that changes can be measured at this young age. Previous activity-based therapies may have been applied too late in development. A randomized controlled trial is now underway to determine if intensive leg therapy improves the outcome of children with early stroke.
(1)从文献中确定皮质脊髓束（CST）成熟的潜在关键期；(2)报告在此期间对 CST 损伤儿童进行强化、基于活动的治疗的初步数据。腿部 CST 的最佳关键期估计是儿童年龄小于 2 岁。此前针对 CST 损伤儿童行走的干预措施主要在这个年龄之后应用。我们对年龄小于 2 岁的儿童进行训练的初步结果显示，行走改善的程度超过了以往所有的报告。此外，我们改进了测量腿部感觉和运动通路的技术，以便在这个年幼的年龄测量到变化。此前的基于活动的治疗可能在发育后期应用得太晚了。目前正在进行一项随机对照试验，以确定腿部强化治疗是否能改善早期中风儿童的预后。
