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体外冲击波疗法(ESWT)对痉挛型脑瘫(CP)患儿有益。

Extracorporeal shockwave therapy (ESWT) benefits in spastic children with cerebral palsy (CP).

作者信息

Mirea A, Onose G, Padure L, Rosulescu E

机构信息

"Dr. Nicolae Robănescu" National Centre of Neuro-Psychomotor Clinical Rehabilitation, Bucharest, Romania ; "Bagdasar-Arseni" Clinical Emergency Hospital, Bucharest, Romania.

"Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania ; "Bagdasar-Arseni" Clinical Emergency Hospital, Bucharest, Romania.

出版信息

J Med Life. 2014;7 Spec No. 3(Spec Iss 3):127-32.

Abstract

INTRODUCTION

ESWT refers to the use of Shock Waves in medical practice. It was used as an important tool in spasticity management of children with CP. The aim of our study was to evaluate the effect of a 3 session of ESWT on spastic upper and lower limbs muscles in children with CP.

METHODS

Sixty-three children (37 boys and 26 girls), mean age 99.57±53.74 months, were included in the study. We used focused ESWT, applied in 3 sessions during the admission of each child, on the mainly affected muscles, using the same parameters on all patients (energy - 0.15 mJ/mm2, shot dose - 500 shocks/ session, frequency - 10 Hz). All patients were assessed two times: once, in admission (before any physical or ESWT appliance) and second, at discharge (after receiving the entire prescribed treatment), following: Modified Ashworth Scale (MAS), Gross Motor Function Classification System (GMFCS), Gross Motor Function Measure 66 (GMFM-66) and also a Questionnaire on Pain caused by spasticity (QPS).

RESULTS

We found a better and significant decrease of MAS level in the ESWT treated group, thus leading to a concomitant decrease of QPS score and also increase of GMFM-66 score.

CONCLUSION

ESWT, applied in 3 sessions, with 0.15 mJ/ mm2, using 500 shocks/ min and 10 Hz as frequency may decrease children spasticity level and pain caused by it and improve the gross motor function.

摘要

引言

体外冲击波疗法(ESWT)是指在医学实践中使用冲击波。它被用作治疗脑瘫儿童痉挛的重要工具。我们研究的目的是评估3次体外冲击波疗法对脑瘫儿童痉挛性上肢和下肢肌肉的影响。

方法

本研究纳入63名儿童(37名男孩和26名女孩),平均年龄99.57±53.74个月。我们使用聚焦式体外冲击波疗法,在每个儿童住院期间分3次对主要受累肌肉进行治疗,所有患者使用相同参数(能量 - 0.15 mJ/mm²,每次冲击剂量 - 500次,频率 - 10 Hz)。所有患者进行两次评估:一次是在入院时(在任何物理治疗或体外冲击波治疗之前),第二次是在出院时(接受全部规定治疗之后),评估指标如下:改良Ashworth量表(MAS)、粗大运动功能分类系统(GMFCS)、粗大运动功能测量66项(GMFM - 66)以及痉挛性疼痛问卷(QPS)。

结果

我们发现体外冲击波治疗组的MAS水平有更好且显著的降低,从而导致QPS评分随之降低,GMFM - 66评分升高。

结论

分3次应用体外冲击波疗法,能量为0.15 mJ/mm²,频率为每分钟500次、10 Hz,可能会降低儿童的痉挛水平及其引起的疼痛,并改善粗大运动功能。

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