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结缔组织推拿和肌内效贴对脑瘫患儿慢性便秘的影响:一项随机对照试验。

The effects of connective tissue manipulation and Kinesio Taping on chronic constipation in children with cerebral palsy: a randomized controlled trial.

作者信息

Orhan Ceren, Kaya Kara Ozgun, Kaya Serap, Akbayrak Turkan, Kerem Gunel Mintaze, Baltaci Gül

机构信息

a Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation , Hacettepe University , Ankara , Turkey.

出版信息

Disabil Rehabil. 2018 Jan;40(1):10-20. doi: 10.1080/09638288.2016.1236412. Epub 2016 Oct 28.

Abstract

PURPOSE

The aim of this study was to investigate the effects of connective tissue manipulation (CTM) and Kinesio Taping (KT) on constipation and quality of life in children with cerebral palsy (CP).

METHOD

This study was designed as a randomized controlled trial. Forty children diagnosed with chronic constipation based on Rome III criteria were randomly assigned to CTM group [6 females, 7 males; 8 y 6 mo (SD = 3y 4 mo)], KT group [7 female, 7 male; 8y 7 mo (SD =3y 5 mo)] or control group [6 female, 7 male; 8y 3 mo (SD = 3y 6 mo)]. All patients were assessed with 7-day bowel diaries, Bristol Stool Form Scale (BSFS), Visual Analog Scale (VAS), and Pediatric Quality of Life Inventory (PEDsQL). Kruskal-Wallis, Wilcoxon's signed-rank, and Mann-Whitney U tests were used to determine intra-group and inter-group differences. The level of significance was p < 0.05.

RESULTS

Among the CTM, KT, and control groups, there were statistically significant differences regarding the changes in defecation frequency (2.46, 3.00, 0.30, ES 1.16, p < 0.001), duration of defecation (5.07, 5.35, 0.15, ES 2.37, p = 0.003), BSFS (1.84, 2.14, 0.07, ES 0.91, p < 0.001), VAS (4.83, 3.87, 0.23, ES 1.98, p < 0.001), and PEDsQL total scores (7, 14, 8.36, -0.85, ES 4.08, p < 0.001).

CONCLUSIONS

This study revealed that CTM and KT seem equally effective physiotherapy approaches for the treatment of pediatric constipation and these approaches may be added to bowel rehabilitation program. Implications for rehabilitation CTM and KT have similar effectiveness in alleviating the constipation-related symptoms and improving quality of life in children with CP. CTM and KT can be integrated into bowel rehabilitation programs. Considering the characteristics of patients, these treatment options can be used as an alternative of each other by physiotherapists.

摘要

目的

本研究旨在探讨结缔组织推拿(CTM)和肌内效贴布(KT)对脑瘫(CP)患儿便秘及生活质量的影响。

方法

本研究设计为随机对照试验。根据罗马Ⅲ标准诊断为慢性便秘的40名儿童被随机分为CTM组[6名女性,7名男性;8岁6个月(标准差=3岁4个月)]、KT组[7名女性,7名男性;8岁7个月(标准差=3岁5个月)]或对照组[6名女性,7名男性;8岁3个月(标准差=3岁6个月)]。所有患者均通过7天排便日记、布里斯托大便分类法(BSFS)、视觉模拟量表(VAS)和儿童生活质量量表(PEDsQL)进行评估。采用Kruskal-Wallis检验、Wilcoxon符号秩检验和Mann-Whitney U检验来确定组内和组间差异。显著性水平为p<0.05。

结果

在CTM组、KT组和对照组中,排便频率变化(2.46、3.00、0.30,效应量1.16,p<0.001)、排便持续时间(5.07、5.35、0.15,效应量2.37,p=0.003)、BSFS(1.84、2.14、0.07,效应量0.91,p<0.001)、VAS(4.83、3.87、0.23,效应量1.98,p<0.001)以及PEDsQL总分(7、14、8.36,-0.85,效应量4.08,p<0.001)方面存在统计学显著差异。

结论

本研究表明,CTM和KT似乎是治疗小儿便秘同样有效的物理治疗方法,这些方法可添加到肠道康复计划中。康复启示 CTM和KT在缓解CP患儿便秘相关症状及改善生活质量方面具有相似的效果。CTM和KT可纳入肠道康复计划。考虑到患者的特点,物理治疗师可将这些治疗选择相互替代使用。

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