Sadeghi Esmaeil, Jamebozorgi Ali Asghar, Qoreishy Mohamad, Kangarani Farahani Melika
Occupational Therapy, Iran University of Medical Sciences, Tehran, Iran.
Physiotherapy Research Center, School of Rehabilitation , Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Iran J Child Neurol. 2021 Summer;15(3):55-64. doi: 10.22037/ijcn.v15i2.17361.
Cerebral palsy (CP) is a non-progressive Neurodevelopmental disorder mainly treated using Single-event multilevel surgery (SEMLS). SEMLS contains using a casting method to immobilize the operated limb. However, in the present study, in addition to casting, the bandaging method was also applied. Bandaging is a newer method compared to casting. No study has used bandage for post-surgery immobilization. According to the best knowledge of the authors, no study has compared the outcome of bandage and cast for postoperative immobilization regarding the rehabilitation and quality of life (QoL) in the first and third months following the surgery, within the recovery period, which is associated with consequences like caring, hygiene, transferring, and mobility that affect the spirit and function of children. As a result, we decided to investigate the effect of these methods on the QoL of children the following surgery to treat CP.
MATERIALS & METHODS: Following an analytical cross-sectional design, 100 children (aged 4-12 years) were randomly divided into hemiplegic and diplegic CP. The Cerebral Palsy QoL questionnaire (CP QOL-Child) was filled by parents of the participants. Based on the type of administered immobilizer, 80 children were randomly divided into two groups (40 subjects in each group). All subjects were evaluated using a similar questionnaire in the first and third months after surgery. The non-parametric Mann-Whitney test and ANOVA test were used to compare the study groups.
The mean ratio of QoL changes, based on the CP QoL-Child questionnaire, was significantly increased in the bandage group during the first month after surgery. However, for the cast group, this parameter was significantly decreased (P<0.001). In the third month after surgery, the mean ratio of QoL changes was significantly increased in both groups, but the difference in the mean ratio of QoL changes between the two methods wasn't significant (P=0.64).
In the first month after surgery, the bandaging method was more effective than the casting method, but in the third month, the outcomes were similar for both groups.
脑瘫（CP）是一种非进行性神经发育障碍，主要通过单阶段多水平手术（SEMLS）进行治疗。SEMLS包括使用石膏固定法固定手术肢体。然而，在本研究中，除了石膏固定外，还应用了包扎法。与石膏固定相比，包扎法是一种更新的方法。尚无研究使用包扎法进行术后固定。据作者所知，在术后第一个月和第三个月的恢复期内，尚无研究比较包扎法和石膏固定法在康复及生活质量（QoL）方面的术后固定效果，而这一时期会涉及诸如护理、卫生、转移和活动能力等影响儿童精神和功能的后果。因此，我们决定研究这些方法对接受手术治疗CP的儿童术后生活质量的影响。
采用分析性横断面设计，将100名4至12岁的儿童随机分为偏瘫型和双瘫型CP组。由参与者的父母填写脑瘫生活质量问卷（CP QOL-Child）。根据所使用的固定器具类型，将80名儿童随机分为两组（每组40名受试者）。所有受试者在术后第一个月和第三个月使用相似的问卷进行评估。采用非参数曼-惠特尼检验和方差分析来比较研究组。
根据CP QOL-Child问卷，术后第一个月包扎组的生活质量变化平均比值显著增加。然而，石膏固定组的这一参数显著降低（P<0.001）。术后第三个月，两组的生活质量变化平均比值均显著增加，但两种方法的生活质量变化平均比值差异不显著（P=0.64）。
术后第一个月，包扎法比石膏固定法更有效，但在第三个月，两组的结果相似。
