COVID-19 封锁期间的远程康复治疗与脑瘫粗大运动功能：一项观察性研究。
Telerehabilitation during COVID-19 lockdown and gross motor function in cerebral palsy: an observational study.
机构信息
Unit of Physical and Rehabilitation Medicine, Tor Vergata University, Rome, Italy -
Department of Pediatric Neurorehabilitation, Scientific Institute for Research and Health Care Santa Lucia Foundation, Rome, Italy.
出版信息
Eur J Phys Rehabil Med. 2022 Aug;58(4):592-597. doi: 10.23736/S1973-9087.21.07132-X. Epub 2021 Dec 16.
BACKGROUND
COVID-19 (Coronavirus disease 2019) refers to a mainly respiratory disease, caused by a new SARS-CoV-2 virus predominantly transmitted through direct or indirect contact with mucous membranes of eyes, mouth, or nose. The main control measures are physical distancing, use of specific protective devices, hand hygiene and disinfection of environments and tools. During this health emergency, telemedicine and telerehabilitation guaranteed patients to receive continuity of care through a virtual support while maintaining physical distance.
AIM
The aim of this study was to evaluate the effects of telerehabilitation on gross motor skills in children with cerebral palsy (CP) during COVID-19 lockdown.
DESIGN
This is an observational study.
SETTING
Pediatric Outpatient Neurorehabilitation Service.
POPULATION
Fifty-three children with cerebral palsy aged between 6 months and 12 years classified according to the Gross Motor Function Classification System (GMFCS).
METHODS
Variation on the Gross Motor Function Measure-66 (GMFM-66) Score calculated before and after the telerehabilitation period was analyzed.
RESULTS
After telerehabilitation there was a statistically significant increase in the median value of GMFM scores both on the total sample (from 54.82% to 63.18%, P=0.000005) and in the subgroups. Specifically, in children classified as level I and II at the GMFCS, this value increased more after the telerehabilitation period. Only the GMFCS level V group did not show statistically significant changes and only in two cases a decrease in the GMFM Score after the telerehabilitation phase occurred.
CONCLUSIONS
Telerehabilitation can be considered an efficient tool that can temporarily replace the in-person therapy. It can allow the patient or caregiver to acquire skills in performing home exercises and to integrate and implement activity carried out at the Rehabilitation Center.
CLINICAL REHABILITATION IMPACT
This study shows a positive effect of telerehabilitation on gross motor function in children with cerebral palsy.
背景
COVID-19（2019 年冠状病毒病）是一种主要的呼吸道疾病，由新型 SARS-CoV-2 病毒引起，主要通过直接或间接接触眼睛、口腔或鼻腔的粘膜传播。主要的控制措施是保持身体距离、使用特定的防护设备、手部卫生和环境及工具消毒。在这次卫生紧急情况下，远程医疗和远程康复通过虚拟支持确保患者在保持身体距离的同时获得连续的护理。
目的
本研究旨在评估 COVID-19 封锁期间远程康复对脑瘫儿童粗大运动技能的影响。
设计
这是一项观察性研究。
设置
儿科门诊神经康复服务。
人群
53 名年龄在 6 个月至 12 岁之间的脑瘫儿童，根据粗大运动功能分类系统（GMFCS）进行分类。
方法
分析远程康复前后 GMFM-66 评分的变化。
结果
远程康复后，GMFM 评分的中位数在总样本（从 54.82%增加到 63.18%，P=0.000005）和亚组中均有统计学显著增加。具体而言，在 GMFCS 分级为 I 和 II 的儿童中，在远程康复后，该值增加更多。仅 GMFCS 分级 V 组的变化没有统计学意义，并且只有在两个病例中，在远程康复阶段后 GMFM 评分出现下降。
结论
远程康复可以被认为是一种有效的工具，可以暂时替代面对面的治疗。它可以使患者或护理人员获得在家中进行运动的技能，并整合和实施在康复中心进行的活动。
临床康复影响
本研究显示远程康复对脑瘫儿童粗大运动功能有积极影响。
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