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常规物理治疗对脑瘫患儿痉挛的作用

The Role of Regular Physical Therapy on Spasticity in Children With Cerebral Palsy.

作者信息

Lee Heewon, Kim Eun Kyung, Son Dong Baek, Hwang Youngdeok, Kim Joon-Sung, Lim Seong Hoon, Sul Bomi, Hong Bo Young

机构信息

Department of Rehabilitation Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.

Department of Statistics, Sungkyunkwan University, Seoul, Korea.

出版信息

Ann Rehabil Med. 2019 Jun;43(3):289-296. doi: 10.5535/arm.2019.43.3.289. Epub 2019 Jun 28.

Abstract

OBJECTIVE

To investigate the effect of physical therapy (PT) intervention on spasticity in patients with cerebral palsy (CP), and to assess the degree of deterioration of spasticity when regular PT is interrupted in those patients.

METHODS

We recruited 35 children with spastic CP who visited our hospital for PT, and whose Modified Tardieu Scale (MTS) scores were serially recorded including before and after a 10-day public holiday time frame period. The outcome measures were the angle of range of motion (ROM) of dorsiflexion of the ankle joint (R1 and R2) in the knee flexion and extension positions as assessed using the MTS.

RESULTS

The range of dorsiflexion of the ankle joint (R1 and R2) after the holiday period was significantly decreased as compared with that measured ROM noted before the holiday period, regardless of the knee position, age, or gross motor function. The dynamic component of the MTS (R2-R1) showed a slight decrease in the knee flexion position.

CONCLUSION

Interruption of regular PT aggravated spasticity and decreased ankle joint ROM in children with spastic CP. Our findings suggest that regular PT in the care continuum for children with CP is crucial for the maintenance of ROM in the spastic ankle joints.

摘要

目的

探讨物理治疗(PT)干预对脑瘫(CP)患者痉挛的影响,并评估这些患者中断常规PT时痉挛的恶化程度。

方法

我们招募了35名因PT前来我院就诊的痉挛型CP儿童,并连续记录其改良Tardieu量表(MTS)评分,包括在10天公共假期时间段前后的评分。结局指标是使用MTS评估的膝关节屈伸位时踝关节背屈活动度(ROM)角度(R1和R2)。

结果

与假期前测量的ROM相比,假期后踝关节背屈活动度(R1和R2)显著降低,与膝关节位置、年龄或粗大运动功能无关。MTS的动态成分(R2-R1)在膝关节屈曲位略有下降。

结论

中断常规PT会加重痉挛型CP儿童的痉挛并降低踝关节ROM。我们的研究结果表明,在CP儿童的连续护理中进行常规PT对于维持痉挛性踝关节的ROM至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85fe/6637053/dc9a11296714/arm-2019-43-3-289f1.jpg

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