School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia.
Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia.
Dev Med Child Neurol. 2020 Dec;62(12):1406-1413. doi: 10.1111/dmcn.14648. Epub 2020 Aug 9.
To test the efficacy of functional electrical stimulation (FES) cycling, goal-directed training, and adapted cycling, compared with usual care, to improve function in children with cerebral palsy (CP).
The intervention was delivered between 2017 and 2019 and included three sessions per week for 8 weeks (2×1h sessions at a children's hospital, and 1h home programme/week). Hospital sessions included 30 minutes of FES cycling and 30 minutes of goal-directed training. Home programmes included goal-directed training and adapted cycling. The comparison group continued usual care. Primary outcomes were gross motor function assessed by the Gross Motor Function Measure (GMFM) and goal performance/satisfaction assessed using the Canadian Occupational Performance Measure (COPM). Secondary outcomes were sit-to-stand and activity capacity, participation in home, school, and community activities, and power output. Linear regression was used to determine the between-group mean difference immediately post-training completion after adjusting for baseline scores.
This randomized controlled trial included 21 participants (mean age=10y 3mo, standard deviation [SD]=3y; Gross Motor Function Classification System level: II=7, III=6, IV=8) who were randomized to the intervention (n=11) or usual care group (n=10). Between-group differences at T2 favoured the intervention group for GMFM-88 (mean difference=7.4; 95% confidence interval [CI]: 2.3-12.6; p=0.007), GMFM-66 (mean difference=5.9; 95% CI: 3.1-8.8; p<0.001), COPM performance (mean difference=4.4; 95% CI: 3.9-5.3; p<0.001) and satisfaction (mean difference=5.2; 95% CI: 4.0-6.4; p<0.001).
Children with CP achieved meaningful functional improvements after FES cycling, goal-directed training, and adapted cycling training. Cycling programmes for children with CP should be individualized and goal directed.
比较功能性电刺激（FES）自行车运动、目标导向训练和适应性自行车运动与常规护理相比，对脑瘫（CP）儿童功能的疗效。
干预措施于 2017 年至 2019 年实施，包括每周 3 次，共 8 周（儿童医院进行 2 次 1 小时的课程，每周 1 次 1 小时的家庭课程）。医院课程包括 30 分钟的 FES 自行车运动和 30 分钟的目标导向训练。家庭课程包括目标导向训练和适应性自行车运动。对照组继续接受常规护理。主要结局指标是使用粗大运动功能测量（GMFM）评估的粗大运动功能和使用加拿大职业表现测量（COPM）评估的目标表现/满意度。次要结局指标是从坐到站、活动能力、家庭、学校和社区活动参与情况以及功率输出。线性回归用于确定在调整基线评分后，训练完成后立即的组间平均差异。
这项随机对照试验纳入了 21 名参与者（平均年龄 10 岁 3 个月，标准差 [SD]=3 岁；粗大运动功能分类系统水平：II=7，III=6，IV=8），他们被随机分配到干预组（n=11）或常规护理组（n=10）。T2 时，组间差异有利于干预组 GMFM-88（平均差异=7.4；95%置信区间 [CI]：2.3-12.6；p=0.007）、GMFM-66（平均差异=5.9；95% CI：3.1-8.8；p<0.001）、COPM 表现（平均差异=4.4；95% CI：3.9-5.3；p<0.001）和满意度（平均差异=5.2；95% CI：4.0-6.4；p<0.001）。
脑瘫儿童在接受 FES 自行车运动、目标导向训练和适应性自行车运动训练后，实现了有意义的功能改善。脑瘫儿童的自行车运动计划应个体化并以目标为导向。
