物理治疗改善痉挛性脑瘫便秘的疗效。

Effectiveness of Physical Therapy for Improving Constipation In Spastic Cerebral Palsy.

出版信息

Altern Ther Health Med. 2021 Jun;27(S1):185-189.

Abstract

BACKGROUND

Bowel and bladder problems in children with cerebral palsy (CP) negatively affect both the children and their families. Routine physical therapy (PT) may contribute to relieving constipation in children with CP by reducing spasticity.

OBJECTIVE

To determine the effectiveness of PT in relieving constipation in children with spastic CP.

DESIGN

This was a single-blinded randomized crossover trial (Clinical Trail # NCT03379038) that included 35 children with spastic CP. The children who fulfilled the inclusion criteria were randomly assigned to one of two groups: the progressive physical therapy (PPT) or the maintenance physical therapy (MPT) group.

METHODS

Data was collected via general demographic questionnaire, defecation frequency (DF) questionnaire, Constipation Assessment Scale (CAS) and the Modified Ashworth Scale (MAS) at baseline and at the 2nd, 4th, and 6th week before and after crossover. The Mann Whitney U-test was used for between-group comparisons and the Friedman and Wilcoxon signed-rank test for post hoc analysis tests were used for within-group changes. To determine the relationship between spasticity and constipation, simple linear regression was used.

SETTING

National Institute of Rehabilitation Medicine, Islamabad, Pakistan.

RESULTS

Neither group showed a significant difference in spasticity level or DF at baseline or at the end of the 2nd week. However, at the end of the 4th week (PPT = 4[1] vs MPT = 2[1]; U = 192; P < .001) and 6th week (PPT = 4[1] vs 3(1); U = 158; P < .001) DF was significantly better in the PPT group than in the MPT group. Regarding constipation severity, the PPT group showed significantly better results on all items of the Constipation Assessment Scale (CAS) compared with the MPT group after intervention (P < .001). The results showed that spasticity was significantly correlated with DF (r = -0.81; P < .001) and constipation severity (r = 0.45; P < .001).

CONCLUSION

Physical therapy significantly improves DF and reduces constipation severity in children with spastic CP.

摘要

背景

脑瘫儿童的肠道和膀胱问题对儿童及其家庭都有负面影响。常规物理治疗（PT）通过降低痉挛程度可能有助于缓解脑瘫儿童的便秘。

目的

确定 PT 缓解痉挛性脑瘫儿童便秘的效果。

设计

这是一项单盲随机交叉试验（临床试验 #NCT03379038），纳入了 35 名痉挛性脑瘫儿童。符合纳入标准的儿童被随机分配到两组之一：渐进式物理治疗（PPT）或维持性物理治疗（MPT）组。

方法

在交叉前和交叉后的第 2、4 和 6 周，使用一般人口统计学问卷、排便频率（DF）问卷、便秘评估量表（CAS）和改良 Ashworth 量表（MAS）收集数据。使用 Mann-Whitney U 检验进行组间比较，Friedman 和 Wilcoxon 符号秩检验进行组内变化的事后分析检验。为了确定痉挛程度与便秘之间的关系，使用简单线性回归。

地点

巴基斯坦伊斯兰堡国家康复医学研究所。

结果

两组在基线或第 2 周末的痉挛程度或 DF 均无显著差异。然而，在第 4 周末（PPT = 4[1] vs MPT = 2[1]；U = 192；P <.001）和第 6 周末（PPT = 4[1] vs 3[1]；U = 158；P <.001），PPT 组的 DF 明显优于 MPT 组。关于便秘严重程度，PPT 组在干预后在便秘评估量表（CAS）的所有项目上均显示出明显优于 MPT 组的结果（P <.001）。结果表明，痉挛程度与 DF（r = -0.81；P <.001）和便秘严重程度（r = 0.45；P <.001）呈显著相关。