Audu Olukemi, Daly Carol
a Physical Therapy Department, School of Health Professions and Studies , University of Michigan-Flint , Flint , MI , USA.
Physiother Theory Pract. 2017 Feb;33(2):162-172. doi: 10.1080/09593985.2016.1265621. Epub 2017 Jan 10.
There is limited evidence to fully justify the use of standing interventions for children with cerebral palsy (CP). This case report describes the impact of an 8-week standing program on motor function in a child with severe CP living in western Africa.
The subject was diagnosed with ischemic - hypoxic encephalopathy shortly after birth and with CP at 12 months of age. Gross Motor Function Classification of CP was level IV. Early attempts at physical therapy were interrupted by limited access to medical services. At 18 months, a standing program using a locally constructed standing frame was initiated. The standing intervention was completed at home 5 times a week for 8 weeks. Motor skills were assessed at baseline and post-intervention using the Gross Motor Function Measure (GMFM-66).
Scores on the GMFM-66 increased from 28 at baseline to 37.4 in 8 weeks. Improvements in motor function included improved head control, improved upper extremity function, and increased sitting ability.
Implementation of a home-based standing program may have contributed to improved motor skills for this child. Further research is needed to determine the effect of standing interventions on functional motor development for children with severe CP.
目前仅有有限的证据能充分证明对脑瘫(CP)患儿采用站立干预的合理性。本病例报告描述了一项为期8周的站立训练计划对一名生活在西非的重度脑瘫患儿运动功能的影响。
该患儿出生后不久被诊断为缺血缺氧性脑病,12个月大时被诊断为脑瘫。脑瘫的粗大运动功能分级为IV级。早期的物理治疗尝试因医疗服务获取有限而中断。18个月大时,开始使用当地制作的站立架进行站立训练计划。站立干预在家庭中每周进行5次,持续8周。在基线期和干预后使用粗大运动功能测量量表(GMFM - 66)对运动技能进行评估。
GMFM - 66评分从基线期的28分在8周内提高到了37.4分。运动功能的改善包括头部控制能力提高、上肢功能改善以及坐位能力增强。
实施家庭站立训练计划可能有助于该患儿运动技能的提高。需要进一步研究以确定站立干预对重度脑瘫患儿功能性运动发育的影响。