Yi Tae Im, Jin Ju Ryeon, Kim Sung Heon, Han Kyung Hee
Department of Rehabilitation Medicine, Bundang Jesaeng General Hospital, Seongnam, Korea.
Ann Rehabil Med. 2013 Oct;37(5):649-57. doi: 10.5535/arm.2013.37.5.649. Epub 2013 Oct 29.
To investigate the factors which contribute to the improvements of the gross motor function in children with spastic cerebral palsy after physical therapy.
The subjects were 45 children with spastic cerebral palsy with no previous botulinum toxin injection or operation history within 6 months. They consisted of 24 males (53.3%) and 21 females (46.7%), and the age of the subjects ranged from 2 to 6 years, with the mean age being 41±18 months. The gross motor function was evaluated by Gross Motor Function Measure (GMFM)-88 at the time of admission and discharge, and then, the subtractions were correlated with associated factors.
The GMFM-88 was increased by 7.17±3.10 through 52±16 days of physical therapy. The more days of admission, the more improvements of GMFM-88 were attained. The children with initial GMFM-88 values in the middle range showed more improvements in GMFM-88 (p<0.05). The children without dysphagia and children with less spasticity of lower extremities also showed more improvements in GMFM-88 (p<0.05).
We can predict the improvements of the gross motor function after physical therapy according to the days of admission, initial GMFM-88, dysphagia, and spasticity of lower extremities. Further controlled studies including larger group are necessary.
探讨物理治疗后痉挛型脑瘫患儿粗大运动功能改善的相关因素。
选取45例痉挛型脑瘫患儿，6个月内无肉毒毒素注射或手术史。其中男24例（53.3%），女21例（46.7%），年龄2至6岁，平均年龄41±18个月。入院时及出院时采用粗大运动功能测量量表（GMFM）-88评估粗大运动功能，然后将差值与相关因素进行相关性分析。
经过52±16天的物理治疗，GMFM-88提高了7.17±3.10。住院天数越多，GMFM-88改善越明显。初始GMFM-88值处于中等范围的患儿GMFM-88改善更明显（p<0.05）。无吞咽困难的患儿及下肢痉挛程度较轻的患儿GMFM-88改善也更明显（p<0.05）。
可根据住院天数、初始GMFM-88、吞咽困难及下肢痉挛情况预测物理治疗后粗大运动功能的改善情况。有必要开展包括更大样本量的进一步对照研究。
