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