儿科评估中的特殊注意事项。

Special Considerations in Pediatric Assessment.

作者信息

Kim Heakyung, Shin Mi Ran

机构信息

Department of Rehabilitation and Regenerative Medicine, Pediatric Physical Medicine and Rehabilitation, Columbia University Irving Medical Center, Weill Cornell Medical College, NewYork-Presbyterian Hospital, 180 Fort Washington Avenue, Harkness Pavilion Suite 165, New York, NY 10032, USA; Department of Physiatry, Blythedale Children's Hospital, Valhalla, NY 10595, USA.

Department of Physical Medicine and Rehabilitation, Johns Hopkins University, 600 North Wolfe Street Phipps 160, Baltimore, MD 21287, USA.

出版信息

Phys Med Rehabil Clin N Am. 2018 Aug;29(3):455-471. doi: 10.1016/j.pmr.2018.03.002. Epub 2018 May 28.

DOI:10.1016/j.pmr.2018.03.002

PMID:30626508

Abstract

Pediatric spasticity management requires special consideration because of continuous growth and underlying medical complications due to upper motor neuron disease. Early intervention, regular follow-up, and management of spasticity are critical to improve function and prevent musculoskeletal complications, functional deterioration, and the development of pain. Thorough history taking along with comprehensive medical evaluation and physical examination by practitioners with knowledge about spasticity are important clues for spasticity management in addition to thorough history taking and review of current medications. This article reviews the rationale of early intervention and continuum of care, basic physical examination, and therapeutic options for spasticity management and spasticity's aggravating factors.

摘要

由于小儿持续生长以及上运动神经元疾病引发的潜在医学并发症，小儿痉挛的管理需要特别考虑。早期干预、定期随访以及痉挛的管理对于改善功能、预防肌肉骨骼并发症、功能恶化和疼痛的发生至关重要。除了详细的病史采集和当前用药审查外，由了解痉挛的从业者进行全面的医学评估和体格检查，是痉挛管理的重要线索。本文综述了早期干预和连续护理的基本原理、基本体格检查、痉挛管理的治疗选择以及痉挛的加重因素。