Skoutelis Vasileios C, Kanellopoulos Anastasios D, Vrettos Stamatis G, Dimitriadis Zacharias, Kalamvoki Efstratia, Dinopoulos Argirios, Papagelopoulos Panayiotis J, Vrettos Stefanos S, Kontogeorgakos Vasileios A
Medical School, National and Kapodistrian University of Athens, Athens, Attica, Greece.
Laboratory of Neuromuscular & Cardiovascular Study of Motion, Department of Physiotherapy, School of Health and Caring Sciences, University of West Attica, Egaleo, Attica, Greece.
J Orthop. 2021 Sep 14;27:122-129. doi: 10.1016/j.jor.2021.09.004. eCollection 2021 Sep-Oct.
This non-randomised controlled trial investigated whether a combined programme of functional physiotherapy and minimally invasive orthopaedic surgery improves the level and degree of capacity and performance of gross motor function in children with spastic cerebral palsy (CP).
Fifty-two children with spastic CP aged 5-7 years, Gross Motor Function Classification System (GMFCS) levels II-IV, were allocated to two equal groups: experimental group (selective percutaneous myofascial lengthening [SPML] procedure and 9-month functional strengthening physiotherapy programme) and control (standard physiotherapy) groups. At baseline and at the end of the 9-month intervention, the capacity and performance of gross motor function were assessed with the Gross Motor Function Measure (GMFM) D and E subcategories and Functional Mobility Scale (FMS), respectively. The level of gross motor function was measured with the GMFCS.
There was a statistically significant difference in the post-intervention improvements in the GMFM D (experimental mean difference = 19.63 ± 10.46; control mean difference = 2.40 ± 4.62) and E (experimental mean difference = 19.33 ± 11.82; control mean difference = 4.20 ± 6.26) between experimental and control group ( < 0.001). There was a significant improvement in the GMFCS level and each FMS distance for the experimental group ( < 0.001), but not for the control group ( > 0.05).
SPML procedure combined with functional physiotherapy improves gross motor function in children with spastic CP, by raising the degree and level of motor independence.
本非随机对照试验研究了功能性物理治疗与微创矫形手术相结合的方案是否能改善痉挛型脑瘫（CP）患儿的总体运动功能能力和表现水平及程度。
52名年龄在5至7岁、总体运动功能分类系统（GMFCS）为II - IV级的痉挛型CP患儿被分为两组，每组人数相等：实验组（选择性经皮肌筋膜延长术[SPML]及为期9个月的功能性强化物理治疗方案）和对照组（标准物理治疗）。在基线期和9个月干预结束时，分别使用总体运动功能测量（GMFM）D和E子类别以及功能性移动量表（FMS）评估总体运动功能的能力和表现。使用GMFCS测量总体运动功能水平。
实验组和对照组在干预后GMFM D（实验组平均差异 = 19.63 ± 10.46；对照组平均差异 = 2.40 ± 4.62）和E（实验组平均差异 = 19.33 ± 11.82；对照组平均差异 = 4.20 ± 6.26）方面存在统计学显著差异（< 0.001）。实验组的GMFCS水平和每个FMS距离均有显著改善（< 0.001），而对照组则无（> > 0.05）。
SPML手术联合功能性物理治疗可通过提高运动独立性的程度和水平来改善痉挛型CP患儿的总体运动功能。
