Hart Emerson, Humanitzki Elizabeth, Schroeder Julia, Woodbury Michelle, Coker-Bolt Patty, Dodds Cindy
College of Health Professions, Medical University of South Carolina, Charleston, SC.
College of Health Professions, Medical University of South Carolina, Charleston, SC.
Semin Pediatr Neurol. 2022 Dec;44:100994. doi: 10.1016/j.spen.2022.100994. Epub 2022 Sep 10.
Pediatric stroke is a condition that often results in life-long motor, cognitive, or sensory deficits for children. The purpose of this focused review is to compile the most recent literature on pediatric stroke neuromotor interventions and summarize evidence for use by rehabilitation providers and researchers. Terms including stroke, pediatric, and neuromotor were searched with appropriate MeSH terms. Information was collected regarding interventions conducted and outcome measures used for each article. Interventions and outcome measures were organized based on ICF components (Body Structure and Function, Activity, Participation, and Environmental Factors). 16 articles were included after full-text screens. From these 16 articles, a large majority of them included some form of neuromodulation as a part of intervention. Results identified a potentially problematic gap between domains addressed by interventions and measured by outcomes, with a need to include more expansive outcome measures in research studies. There are several areas of potential growth in pediatric stroke literature. Research studies should be precise when describing included samples. As interventions for pediatric stroke shift toward neuromodulation and other neurologic treatments, there is a need for well-defined populations, both clinically in the community as well as in research studies. There is also a need for US guidelines for rehabilitation after pediatric stroke. Overall, the trend in the literature seems to suggest that combining some form of neuromodulatory technique with existing recommended rehabilitation technique (ex: CIMT) may promote overall recovery for children after stroke, though further research is needed.
小儿中风是一种常常会导致儿童出现终身运动、认知或感觉功能障碍的病症。这篇重点综述的目的是汇编有关小儿中风神经运动干预的最新文献，并总结相关证据，以供康复治疗人员和研究人员参考。使用适当的医学主题词（MeSH）检索了包括中风、小儿和神经运动等术语。收集了每篇文章中所进行的干预措施及所使用的结局指标的相关信息。干预措施和结局指标根据国际功能、残疾和健康分类（ICF）的组成部分（身体结构和功能、活动、参与及环境因素）进行整理。经过全文筛选后纳入了16篇文章。在这16篇文章中，绝大多数都将某种形式的神经调节作为干预措施的一部分。结果发现，干预措施所涉及的领域与结局指标所衡量的领域之间存在潜在的问题差距，研究中需要纳入更广泛的结局指标。小儿中风文献有几个潜在的发展领域。研究在描述所纳入的样本时应做到精确。随着小儿中风的干预措施转向神经调节和其他神经治疗，无论是在社区临床还是在研究中，都需要明确界定人群。还需要美国小儿中风后康复指南。总体而言，文献中的趋势似乎表明，将某种形式的神经调节技术与现有的推荐康复技术（如强制性诱导运动疗法）相结合，可能会促进中风后儿童的整体恢复，不过仍需要进一步研究。
