Department of Rehabilitation Sciences, KU Leuven, Bruges, Belgium.
Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.
Disabil Rehabil. 2020 Jun;42(11):1548-1555. doi: 10.1080/09638288.2018.1528637. Epub 2019 Jan 8.
This cross-sectional study aims to investigate the presence and severity of overflow movements of dystonia and choreoathetosis in dyskinetic cerebral palsy (CP) and to assess the relationship of overflow movements with functional classification scales. Fifty-two subjects with dyskinetic CP were included. Presence and severity of dystonia and choreoathetosis overflow movements were assessed with the Dyskinesia Impairment Scale. Functional abilities were classified with the Gross Motor Function Classification System, Manual Ability Classification System, Viking Speech Scale, Communication Function Classification System, and Eating and Drinking Ability Classification System. Dystonia and choreoathetosis overflow movements were simultaneously present. Median scores of dystonia overflow movements were significantly higher than choreoathetosis overflow movements. Dystonia and choreoathetosis overflow movements were significantly higher in extremities than in the central body. Correlations between dystonia and choreoathetosis overflow movements were fair. Moderate to good correlations were found between dystonia overflow score and Gross Motor Function Classification System, Manual Ability Classification System, and Eating and Drinking Ability Classification System. This is the first study to assess overflow movements in dyskinetic CP. All participants presented with dystonia and choreoathetosis overflow movements, with higher values for dystonia overflow movements. Dystonia overflow movements seem to have a larger impact on functional abilities.Implications for rehabilitationDystonia and choreoathetosis overflow movements are both present in children with dyskinetic cerebral palsy, with dystonia overflow movements being more severe than choreoathetosis overflow movements.Overflow movements impact heavily on daily functional ability and the execution of voluntary activities.Dystonia overflow movements show good correlations with functional classification scales.The measurable characteristics of overflow movements can be used as a guideline for targeted treatment with, e.g., botulinum-toxin-A injections.
这项横断面研究旨在探讨不随意运动型脑瘫患者中是否存在和严重程度的肌张力障碍和舞蹈徐动症的溢出运动，并评估溢出运动与功能分类量表的关系。共纳入 52 例不随意运动型脑瘫患者。使用不随意运动障碍量表评估肌张力障碍和舞蹈徐动症溢出运动的存在和严重程度。使用粗大运动功能分类系统、手动能力分类系统、维金语音量表、沟通功能分类系统和饮食能力分类系统对功能能力进行分类。存在肌张力障碍和舞蹈徐动症的溢出运动。肌张力障碍溢出运动的中位数评分明显高于舞蹈徐动症溢出运动。四肢的肌张力障碍和舞蹈徐动症溢出运动明显高于中央身体。肌张力障碍和舞蹈徐动症溢出运动之间存在中度至高度相关性。肌张力障碍溢出评分与粗大运动功能分类系统、手动能力分类系统和饮食能力分类系统之间存在中度至良好相关性。这是第一项评估不随意运动型脑瘫患者溢出运动的研究。所有参与者均存在肌张力障碍和舞蹈徐动症的溢出运动，且肌张力障碍溢出运动的数值较高。肌张力障碍溢出运动似乎对功能能力的影响更大。
康复的意义
不随意运动型脑瘫患儿均存在肌张力障碍和舞蹈徐动症的溢出运动，且肌张力障碍溢出运动比舞蹈徐动症溢出运动更严重。溢出运动对日常功能能力和自主活动的执行有很大影响。肌张力障碍溢出运动与功能分类量表有很好的相关性。溢出运动的可测量特征可作为靶向治疗（如肉毒毒素 A 注射）的指导。
