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神经肌肉电刺激联合或不联合强化训练对痉挛型脑瘫的治疗效果评估

Therapeutic Effect Evaluation of Neuromuscular Electrical Stimulation With or Without Strengthening Exercise on Spastic Cerebral Palsy.

作者信息

Qi Ya-Chao, Niu Xiao-Li, Gao Ya-Ran, Wang He-Bo, Hu Ming, Dong Li-Peng, Li Ya-Zhou

机构信息

1 Hebei General Hospital, Shijiazhuang, China.

2 The Third Hospital of Hebei Medical University, Shijiazhuang, China.

出版信息

Clin Pediatr (Phila). 2018 May;57(5):580-583. doi: 10.1177/0009922817732619. Epub 2017 Oct 9.

DOI:10.1177/0009922817732619
PMID:28990434
Abstract

The aims of this study were to investigate the effect of neuromuscular electrical stimulation (NMES) combined with strengthening exercise on movement in children with spastic cerebral palsy (CP). One hundred children with spastic CP were randomly divided into a treatment group (NMES and strengthening exercise, n = 50) and a control group (only NMES, n = 50). We compared the Comprehensive Spasticity Scale (CSS) score, Gross Motor Function Measure (GMFM) score, and walking speed before treatment and 6 weeks and 3 months after treatment between the 2 groups. There was no difference in CSS score between the treatment and control groups before the therapy (12.0 ± 3.4 vs 12.3 ± 3.6), which decreased much more in the treatment group after 6 weeks (7.6 ± 3.0 vs 9.5 ± 2.8) and 3 months (7.4 ± 2.4 vs 9.4 ± 2.6) with significant differences ( P < .05). No difference in GMFM score was observed between the treatment and control groups before the therapy (44.5 ± 13.2 vs 44.0 ± 12.6), which increased much more in the treatment group after 6 weeks (70.6 ± 15.2 vs 56.7 ± 14.3) and 3 months (71.0 ± 16.4 vs 58.0 ± 15.6) with significant differences ( P < .05). The walking speed improved over time, which was the same before the treatment (0.43 ± 0.13 m/s vs 0.45 ± 0.14 m/s), and was significantly greater in the treatment group than that in the control group (6 weeks: 0.69 ± 0.15 m/s vs 0.56 ± 0.12 m/s, P < .05; 3 months: 0.72 ± 0.17 m/s vs 0.57 ± 0.18 m/s, P < .05). NMES combined with strengthening exercise was more effective than NMES alone in the recovery of spastic CP.

摘要

本研究旨在探讨神经肌肉电刺激(NMES)联合强化训练对痉挛型脑瘫(CP)患儿运动功能的影响。100例痉挛型CP患儿被随机分为治疗组(NMES联合强化训练,n = 50)和对照组(仅NMES,n = 50)。我们比较了两组治疗前、治疗6周后和3个月后的综合痉挛量表(CSS)评分、粗大运动功能测量(GMFM)评分及步行速度。治疗组与对照组治疗前CSS评分无差异(12.0±3.4 vs 12.3±3.6),但治疗组在6周后(7.6±3.0 vs 9.5±2.8)和3个月后(7.4±2.4 vs 9.4±2.6)下降幅度更大,差异有统计学意义(P < 0.05)。治疗组与对照组治疗前GMFM评分无差异(44.5±13.2 vs 44.0±12.6),但治疗组在6周后(70.6±15.2 vs 56.7±14.3)和3个月后(71.0±16.4 vs 58.0±15.6)升高幅度更大,差异有统计学意义(P < 0.05)。步行速度随时间改善,治疗前两组相同(0.43±0.13 m/s vs 0.45±0.14 m/s),但治疗组显著快于对照组(6周:0.69±0.15 m/s vs 0.56±0.

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