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急性弛缓性脊髓炎:儿科队列中的康复挑战与结果

Acute flaccid myelitis: Rehabilitation challenges and outcomes in a pediatric cohort.

作者信息

Melicosta Michelle E, Dean Janet, Hagen Kaitlin, Oppenheimer Kathleen, Porter Courtney, Rybczynski Suzanne, Salorio Cynthia, Sadowsky Cristina

机构信息

Department of Pediatric Rehabilitation, Kennedy Krieger Institute, Baltimore, MD, USA.

Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, USA.

出版信息

J Pediatr Rehabil Med. 2019;12(3):245-253. doi: 10.3233/PRM-180549.

Abstract

PURPOSE

To describe one institution's experience in the rehabilitation of children with acute flaccid myelitis (AFM). This study reviews the medical and rehabilitative course and functional outcomes of a cohort of children who underwent Activity Based Restorative Therapy (ABRT) at a single center.

METHODS

Children with AFM presenting for rehabilitation between March 2005 and January 2017 were identified and a retrospective chart review was conducted. Changes in medical and functional status were assessed using multiple standardized instruments, as well as a chart review of medical progress.

RESULTS

Thirty-one children with AFM treated at our institution in the study time period were identified. Of these, seventeen received inpatient treatment, and fourteen received solely outpatient interventions. Their medical and functional outcomes are described with use of standardized measures when available.

CONCLUSIONS

Children with flaccid paralysis due to AFM undergoing structured, comprehensive rehabilitation interventions, even when these are initiated long after paralysis onset, can make significant neurologic and functional gains. Recovery of function and prevention of comorbidities are the main therapeutic targets for interventions in this population.

摘要

目的

描述一家机构在急性弛缓性脊髓炎(AFM)患儿康复治疗方面的经验。本研究回顾了一组在单一中心接受基于活动的恢复性治疗(ABRT)的患儿的医疗和康复过程以及功能结局。

方法

确定2005年3月至2017年1月期间前来接受康复治疗的AFM患儿,并进行回顾性病历审查。使用多种标准化工具以及病历审查来评估医疗和功能状态的变化。

结果

在研究期间,本机构共治疗了31例AFM患儿。其中,17例接受了住院治疗,14例仅接受了门诊干预。在可行的情况下,使用标准化测量方法描述了他们的医疗和功能结局。

结论

因AFM导致弛缓性麻痹的患儿接受结构化、全面的康复干预,即使在麻痹发作后很长时间才开始干预,也能在神经和功能方面取得显著改善。功能恢复和预防合并症是该人群干预措施的主要治疗目标。

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