Paleg Ginny, Romness Mark, Livingstone Roslyn
Montgomery County Infants and Toddlers Program, Rockville, MD, USA.
Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA, USA.
J Pediatr Rehabil Med. 2018;11(1):57-70. doi: 10.3233/PRM-170507.
To evaluate evidence supporting physical and occupational therapy interventions used to improve sensory and motor outcomes for children 0-6 years with central hypotonia.
Four electronic databases were searched from 1996 to March 2017. Level of evidence and study conduct was evaluated using American Academy of Cerebral Palsy and Developmental Medicine criteria. Traffic lighting classification identified interventions that were green (proven effective), yellow (possibly effective) or red (proven ineffective or contraindicated).
Thirty-seven articles were included. Nine studies measured orthotic interventions while four distinct studies published over nine articles measured treadmill interventions. Remaining studies measured impact of compression garments, massage, motor and sensori-motor interventions, positioning and mobility interventions.
Green light evidence supports treadmill training (to promote ambulation and gait characteristics) and massage (to positively affect muscle tone, motor development and use of vision) for infants with Down syndrome. These interventions are considered Yellow (possibly effective) for other populations. Green light evidence supports impact of orthoses on foot alignment for ambulatory children with hypotonia, while impact on gait characteristics is Yellow light and motor development may be negatively impacted (Red light) in pre-ambulatory children. All other interventions rated Yellow (possibly effective) and therapists should monitor using sensitive outcome measures.
评估支持物理治疗和职业治疗干预措施用于改善0至6岁中枢性肌张力低下儿童感觉和运动结局的证据。
检索了1996年至2017年3月的四个电子数据库。使用美国脑性瘫痪和发育医学学会的标准评估证据水平和研究实施情况。交通信号灯分类确定了绿色（已证实有效）、黄色（可能有效）或红色（已证实无效或禁忌）的干预措施。
纳入37篇文章。9项研究测量了矫形器干预措施，而4项不同的研究（发表在9篇以上文章中）测量了跑步机干预措施。其余研究测量了压力衣、按摩、运动和感觉运动干预、体位和移动性干预的影响。
绿灯证据支持对唐氏综合征婴儿进行跑步机训练（以促进步行和步态特征）和按摩（对肌张力、运动发育和视力使用产生积极影响）。这些干预措施对其他人群被认为是黄色（可能有效）。绿灯证据支持矫形器对步行的肌张力低下儿童足部对线的影响，而对步态特征的影响为黄灯，对尚不能行走儿童的运动发育可能产生负面影响（红灯）。所有其他干预措施评定为黄色（可能有效），治疗师应使用敏感的结局指标进行监测。
