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肉毒杆菌毒素注射后电刺激对痉挛型双侧瘫脑瘫患儿的疗效:一项前瞻性随机临床研究。

Effectiveness of electrical stimulation after administration of botulinum toxin in children with spastic diplegic cerebral palsy: A prospective, randomized clinical study.

作者信息

Yiğitoğlu Pembe, Kozanoğlu Erkan

机构信息

Department of Physical Medicine and Rehabilitation, Near East University Faculty of Medicine, Lefkoşa, KKTC.

Department of Physical Medicine and Rehabilitation, Çukurova University Faculty of Medicine, Adana, Turkey.

出版信息

Turk J Phys Med Rehabil. 2019 Feb 4;65(1):16-23. doi: 10.5606/tftrd.2019.2236. eCollection 2019 Mar.

DOI:10.5606/tftrd.2019.2236
PMID:31453540
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6648179/
Abstract

OBJECTIVES

The aim of the study was to investigate the effectiveness of electrical stimulation to agonist muscles after injection of Botulinum toxin A (BTX-A) in children with spastic diplegic cerebral palsy (SDCP).

PATIENTS AND METHODS

Between October 2009 and October 2010, 38 patients with SDCP (19 males, 19 females; mean age 6.3 years; range, 4 to 10 years) were included. The patients were able to walk independently or with minimal assistance by foot equine and had spasticity in the calf muscles between Grades 1+ and 3 according to the Modified Ashworth Scale (MAS). The patients received either BTX-A injection + electrical stimulation (Group 1, n=19) or BTX-A injection alone (Group 2, n=19). All patients were evaluated using the MAS, Penn Spasm Frequency Scale (PSFS), Gross Motor Function Measure-88 (GMFM-88) (Dimensions D and E), and walking velocity.

RESULTS

A decrease in spasticity was evident for the right, left, and bilateral lower extremities for both groups (p<0.05). There were no statistically significant differences in the MAS, PSFS, GMFM-88 (Dimensions D and E), and walking velocity between the groups.

CONCLUSION

Our study results showed that both patient groups benefited from the treatment and the administration of electrical stimulation to the gastrocnemius motor points produced no additional benefit for patients with SDCP.

摘要

目的

本研究旨在探讨对痉挛型双侧瘫脑瘫(SDCP)患儿注射A型肉毒毒素(BTX-A)后,对其主动肌进行电刺激的有效性。

患者与方法

纳入2009年10月至2010年10月期间的38例SDCP患儿(男19例,女19例;平均年龄6.3岁;范围4至10岁)。这些患儿能够独立行走或在马蹄足的轻微辅助下行走,根据改良Ashworth量表(MAS),小腿肌肉痉挛程度在1+级至3级之间。患儿被分为两组,一组接受BTX-A注射+电刺激(第1组,n = 19),另一组仅接受BTX-A注射(第2组,n = 19)。所有患者均使用MAS、宾夕法尼亚痉挛频率量表(PSFS)、粗大运动功能测量-88(GMFM-88)(D和E维度)以及步行速度进行评估。

结果

两组患儿的右下肢、左下肢和双侧下肢痉挛程度均明显降低(p<0.05)。两组在MAS、PSFS、GMFM-88(D和E维度)以及步行速度方面无统计学显著差异。

结论

我们的研究结果表明,两组患者均从治疗中获益,对SDCP患者的腓肠肌运动点进行电刺激并未带来额外益处。

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本文引用的文献

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Neuromuscular electrical stimulation for children with cerebral palsy: a review.神经肌肉电刺激治疗脑性瘫痪儿童:综述。
Arch Dis Child. 2012 Apr;97(4):364-71. doi: 10.1136/archdischild-2011-300437.
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Review of electrical stimulation in cerebral palsy and recommendations for future directions.脑性瘫痪中电刺激的综述及未来方向建议
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A single-blinded, randomized pilot study of botulinum toxin type A combined with non-pharmacological treatment for spastic foot.一项关于A型肉毒杆菌毒素联合非药物治疗痉挛性足的单盲随机试验研究。
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