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探讨感觉运动训练对痉挛型偏瘫脑瘫患儿本体感觉的影响。

Investigation of the effect of sensorimotor exercises on proprioceptive perceptions among children with spastic hemiplegic cerebral palsy.

机构信息

Department of Physical Education and Sport Science, University of Tehran Alborz Campus, Tehran, Iran.

Faculty of Physical Education and Sport Sciences, Department of Health and Sports Medicine, University of Tehran, Tehran, Iran.

出版信息

J Hand Ther. 2020 Jul-Sep;33(3):411-417. doi: 10.1016/j.jht.2019.12.003. Epub 2020 Mar 10.

Abstract

STUDY DESIGN

This is a blinded randomized clinical trial.

INTRODUCTION

Sensorimotor exercises may be an effective, noninvasive treatment modality for treating patients with pediatric spastic hemiplegic cerebral palsy (CP).

PURPOSE OF THE STUDY

We aim to evaluate the effect of sensorimotor exercises on the proprioceptive capability among children with spastic hemiplegic CP.

METHODS

This randomized clinical trial was performed on children with spastic hemiplegic CP. Thirty children aged 8 to 12 years old, with spastic hemiplegic CP, were randomly selected and equally divided into experimental and control groups (N = 15 for each). A joint positioning test was used to measure the patients' baseline proprioceptive ability. The exercise program included sensory and motor exercises which lasted for 8 weeks (three 60-min sessions per week). The data were analyzed by using Welch and paired-sample t-test at the significance level of P < .05.

RESULTS

The results indicated that the proprioceptive capability of the upper limb could significantly improve (P = .001, effect size = 0.41, observed power = 0.99) by using simultaneous exercising of the sensorimotor complex. The mean increased from 8.53 ± 1.6 to 10.53 ± 1.19 in the experimental group, whereas it changed from 6.66 ± 3.44 to 6.73 ± 3.15 in the control group.

DISCUSSION

In consistent with other studies, the exercises used in the present study enhanced the proprioceptive capability but not sensory performance of the hands of children with hemiplegic. Synchronous sensory and motor training in children with hemiplegic CP may improve the function and organization of the somatosensory cortex and reduce sensory disturbances. Although parents were subjectively satisfied with the outcome of the exercises, such as independency and life style, however these recordings were not measured in this study.

CONCLUSION

Implementing simultaneous sensorimotor exercises can improve the proprioceptive capability of the hand. Therefore, these exercises can be used in the rehabilitation programs to meet the children's needs with hemiplegic CP.

摘要

研究设计

这是一项盲法随机临床试验。

引言

感觉运动练习可能是治疗小儿痉挛性偏瘫脑瘫(CP)患者的一种有效、非侵入性的治疗方式。

研究目的

我们旨在评估感觉运动练习对痉挛性偏瘫 CP 患儿本体感觉能力的影响。

方法

本随机临床试验对痉挛性偏瘫 CP 患儿进行。随机选择 30 名 8 至 12 岁的痉挛性偏瘫 CP 患儿,分为实验组和对照组(每组 15 名)。采用关节定位试验测量患者的基础本体感觉能力。运动练习包括感觉和运动练习,持续 8 周(每周 3 次,每次 60 分钟)。使用 Welch 和配对样本 t 检验对数据进行分析,显著性水平为 P < 0.05。

结果

结果表明,通过同时进行感觉运动复合体的练习,上肢的本体感觉能力可以显著提高(P = 0.001,效应量= 0.41,观察功率= 0.99)。实验组的平均值从 8.53 ± 1.6 增加到 10.53 ± 1.19,而对照组从 6.66 ± 3.44 增加到 6.73 ± 3.15。

讨论

与其他研究一致,本研究中使用的运动练习增强了偏瘫患儿的本体感觉能力,但对手的感觉功能没有影响。在偏瘫 CP 患儿中同步进行感觉和运动训练可能会改善躯体感觉皮层的功能和组织,减少感觉障碍。尽管家长对运动练习的效果(如独立性和生活方式)主观上感到满意,但本研究并未对此进行测量。

结论

实施同步感觉运动练习可以提高手部的本体感觉能力。因此,这些练习可以用于康复计划,以满足偏瘫 CP 患儿的需求。

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