Pool Dayna, Valentine Jane, Blackmore A Marie, Colegate Jennifer, Bear Natasha, Stannage Katherine, Elliott Catherine
Department of Physiotherapy and Paediatric Rehabilitation, Princess Margaret Hospital for Children, Roberts Road, Subiaco, 6008 Perth, Australia.
Department of Paediatric Rehabilitation, Princess Margaret Hospital for Children, Perth, Australia.
Arch Physiother. 2015 Jul 18;5:5. doi: 10.1186/s40945-015-0005-x. eCollection 2015.
The aim of this paper is to determine whether daily functional electrical stimulation (FES) is effective in improving self-perceptions of individually identified mobility performance problems in children with unilateral spastic cerebral palsy (USCP). We hypothesized that children receiving 8 weeks of FES treatment would have higher scores for self-perceived performance and satisfaction on the Canadian Occupational Performance Measure (COPM) for individually identified priorities than children not receiving FES.
Thirty-two children (mean age 10 y 8 mo SD 3y 3mo) with USCP and a Gross Motor Function Classification System I or II were randomly assigned to the FES treatment group (8 weeks of daily FES) and control group (usual treatments). Participants were assessed at baseline (week 0), post treatment (week 8) and 6 weeks follow-up (week 14). The primary outcome measures were self-perceived scores for performance and satisfaction of child- and parent-identified priorities assessed using the COPM post treatment and at follow-up. The secondary outcome measures were the categorization of the performance problems from the COPM and self-report responses according to the International Classification of Functioning Child and Youth version (ICF-CY). This was clinically important because an understanding of mobility performance problems for children with USCP is needed for family-centred service planning.
Performance scores (mean difference 1.6, 95 % CI 0.1 to 3.2, = 0.034) and satisfaction scores post treatment (mean difference 2.4, 95 % CI 0.5 to 4.2, = 0.004) were significantly higher in the treatment group than in the control group. There were no significant differences between the groups for performance scores at follow up, however there was a significant difference between the groups for satisfaction (mean difference 1.9, 95 % CI 0.1 to 3.8, = 0.03) in favour of the treatment group. Priorities were identified across all levels of the ICF-CY but were most commonly identified in the activity and participation domains of the ICF-CY (79.5 %).
Daily FES applied during everyday walking is effective in addressing self-perceptions of individually identified priorities by improving the performance and satisfaction of functional skills after treatment.
Australian New Zealand Clinical Trials Register ACTRN12614000949684. Registered 4 September 2014.
本文旨在确定每日功能性电刺激（FES）是否能有效改善单侧痉挛性脑瘫（USCP）患儿个体所确认的运动功能问题的自我认知。我们假设，接受8周FES治疗的患儿在加拿大职业性能测量量表（COPM）上，针对个体所确认的优先事项，其自我感知的表现和满意度得分会高于未接受FES治疗的患儿。
32名年龄在10岁8个月（标准差3岁3个月）、GMFCS分级为I级或II级的USCP患儿被随机分为FES治疗组（每日FES治疗8周）和对照组（常规治疗）。在基线期（第0周）、治疗后（第8周）和6周随访期（第14周）对参与者进行评估。主要结局指标是治疗后及随访时使用COPM评估的患儿和家长所确认优先事项的自我感知表现和满意度得分。次要结局指标是根据《国际功能、残疾和健康儿童与青少年版》（ICF-CY）对COPM中的表现问题进行分类以及自我报告的反应结果。这在临床上很重要，因为以家庭为中心的服务规划需要了解USCP患儿的运动功能问题。
治疗组治疗后的表现得分（平均差值1.6，95%置信区间0.1至3.2，P = 0 . 034）和满意度得分（平均差值2.4，95%置信区间0.5至4.2，P = 0 . 004）显著高于对照组。随访时两组的表现得分无显著差异，但在满意度方面两组存在显著差异（平均差值1.9，95%置信区间0.1至3.8，P = 0 . 03），治疗组更优。在ICF-CY的各个层面都确定了优先事项，但最常见于ICF-CY的活动和参与领域（79.5%）。
日常行走过程中应用每日FES，通过改善治疗后功能技能的表现和满意度，能有效解决个体所确认优先事项的自我认知问题。
澳大利亚新西兰临床试验注册中心ACTRN12614000949684。于2014年9月4日注册。
