Ko Eun Jae, Sung In Young, Yuk Jin Sook
Department of Physical Medicine and Rehabilitation, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan.
Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine.
Medicine (Baltimore). 2020 Mar;99(11):e19016. doi: 10.1097/MD.0000000000019016.
This study investigated the stress induced by well-functioning hand constraint in forced-use therapy (FUT) for children with unilateral spastic cerebral palsy (CP).Seventeen children with unilateral spastic CP (mean age 5.8 years) received FUT: 4-week unaffected upper limb immobilization with a short-arm Scotchcast and were encouraged to incorporate it to their daily routines and plays. They were evaluated at pretreatment, immediate post-treatment, and 6 months post-treatment. The Korea-Child Behavior Checklist (K-CBCL) was used to assess the stress degree; box and block test (BBT), Erhardt Developmental Prehension Assessment (EDPA), Quality of Upper Extremity Skill Test (QUEST), and Pediatric Motor Activity Log (PMAL), upper limb function; and Pediatric Evaluation of Disability Inventory (PEDI), daily living activities.In the preschoolers, most scores of K-CBCL tended to increase after FUT; however, there was no significant change in all scale findings after FUT. In the school-aged children, most scores of K-CBCL tended to decrease after FUT; however, there was no significant change in all scale findings after FUT. The findings of the BBT, QUEST, PMAL how often and well subscales significantly improved post-treatment (P < .05).The 4-week FUT with well-functioning hand constraint significantly improved the UL function and did not induce emotional and behavioral problems in children with unilateral spastic CP.
本研究调查了在单侧痉挛性脑瘫（CP）患儿的强制使用疗法（FUT）中，功能良好的手部约束所引发的压力。17名单侧痉挛性CP患儿（平均年龄5.8岁）接受了FUT：使用短臂Scotchcast对未受影响的上肢进行为期4周的固定，并鼓励他们将其融入日常生活和游戏中。在治疗前、治疗后即刻以及治疗后6个月对他们进行评估。使用韩国儿童行为清单（K-CBCL）评估压力程度；使用箱块测试（BBT）、埃尔哈特发育抓握评估（EDPA）、上肢技能质量测试（QUEST）和儿童运动活动日志（PMAL）评估上肢功能；使用儿童残疾评估量表（PEDI）评估日常生活活动。在学龄前儿童中，FUT后K-CBCL的大多数分数倾向于升高；然而，FUT后所有量表结果均无显著变化。在学龄儿童中，FUT后K-CBCL的大多数分数倾向于降低；然而，FUT后所有量表结果均无显著变化。BBT、QUEST、PMAL的频率和良好子量表的结果在治疗后显著改善（P<0.05）。为期4周的功能良好的手部约束FUT显著改善了单侧痉挛性CP患儿的上肢功能，且未引发情绪和行为问题。
