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增强式训练:单侧脑瘫患儿负重对称性、肌肉力量和步行能力的后续变化

Plyometric exercises: subsequent changes of weight-bearing symmetry, muscle strength and walking performance in children with unilateral cerebral palsy.

作者信息

Elnaggar Ragab K, Elbanna Mohammed F, Mahmoud Waleed S, Alqahtani Bader A

机构信息

Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt.

Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia.

出版信息

J Musculoskelet Neuronal Interact. 2019 Dec 1;19(4):507-515.

Abstract

OBJECTIVE

To evaluate the subsequent effects of plyometric training on weight-bearing symmetry, muscle strength, and gait performance in children with unilateral cerebral palsy.

METHODS

Thirty-nine children with spastic hemiplegia (age 8-12 years) were randomly divided into either the PLYO group (=19, received a 30-minute plyometric exercise program plus the traditional physical rehabilitation, twice/week for eight consecutive weeks) or Non-PLYO group (=20, received the traditional physical rehabilitation only). The weight-bearing symmetry index (WB-SI), maximum isometric muscle strength (MIMS) of quadriceps and hamstring muscles, and spatial-temporal gait parameters were assessed pre and post-intervention.

RESULTS

From pre- to post-intervention, changes of WB-SI among PLYO and Non-PLYO groups did not differ significantly (=.81; hindfoot and =.23; forefoot). MIMS of quadriceps and hamstring muscles at 90° knee flexion (=.008 and .013 respectively) increased significantly in PLYO compared to Non-PLYO group. Walking speed (=.033), stride length (=.002), and step time (<.001) improved markedly in PLYO group more than in Non-PLYO group. The proportion of single leg support (=.14) among PLYO and Non-PLYO groups did not differ significantly.

CONCLUSION

Addition of plyometric exercises to the physical rehabilitation programs of children with unilateral CP could achieve greater improvement in muscles strength and walking performance, but not in WB-SI.

摘要

目的

评估增强式训练对单侧脑瘫患儿负重对称性、肌肉力量和步态表现的后续影响。

方法

39名痉挛性偏瘫儿童(年龄8 - 12岁)被随机分为增强式训练组(n = 19,接受30分钟的增强式训练计划加传统物理康复治疗,每周两次,连续八周)或非增强式训练组(n = 20,仅接受传统物理康复治疗)。在干预前后评估负重对称指数(WB - SI)、股四头肌和腘绳肌的最大等长肌力(MIMS)以及时空步态参数。

结果

从干预前到干预后,增强式训练组和非增强式训练组之间WB - SI的变化无显著差异(后足P = 0.81;前足P = 0.23)。与非增强式训练组相比,增强式训练组在膝关节屈曲90°时股四头肌和腘绳肌的MIMS显著增加(分别为P = 0.008和P = 0.013)。增强式训练组的步行速度(P = 0.033)、步长(P = 0.002)和步幅时间(P < 0.001)比非增强式训练组有更明显的改善。增强式训练组和非增强式训练组之间单腿支撑的比例(P = 0.14)无显著差异。

结论

在单侧脑瘫患儿的物理康复计划中增加增强式训练可以在肌肉力量和步行表现方面取得更大的改善,但在负重对称指数方面没有改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/77a7/6944802/4129a8e7e64f/JMNI-19-507-g002.jpg

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