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朝向与脑瘫相关的运动障碍的功能改善。

Towards functional improvement of motor disorders associated with cerebral palsy.

机构信息

Neurorehabilitation Technology Lab, Department of Rehabilitation Sciences, KU Leuven, Campus Bruges, Bruges, Belgium.

Cerebral Palsy Alliance Research Institute, Specialty of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.

出版信息

Lancet Neurol. 2023 Mar;22(3):229-243. doi: 10.1016/S1474-4422(23)00004-2. Epub 2023 Jan 16.

Abstract

Cerebral palsy is a lifelong neurodevelopmental condition arising from non-progressive disorders occurring in the fetal or infant brain. Cerebral palsy has long been categorised into discrete motor types based on the predominance of spasticity, dyskinesia, or ataxia. However, these motor disorders, muscle weakness, hypotonia, and impaired selective movements should also be discriminated across the range of presentations and along the lifespan. Although cerebral palsy is permanent, function changes across the lifespan, indicating the importance of interventions to improve outcomes in motor disorders associated with the condition. Mounting evidence exists for the inclusion of several interventions, including active surveillance, adapted physical activity, and nutrition, to prevent secondary and tertiary complications. Avenues for future research include the development of evidence-based recommendations, low-cost and high-quality alternatives to existing therapies to ensure universal access, standardised cerebral palsy registers to harmonise epidemiological and clinical information, improved adult screening and check-up programmes to facilitate positive lived experiences, and phase 3 trials for new interventions.

摘要

脑瘫是一种终身性神经发育障碍,由胎儿或婴儿大脑中的非进行性疾病引起。脑瘫长期以来一直根据痉挛、运动障碍或共济失调的优势,被分为不同的运动类型。然而,这些运动障碍、肌肉无力、低张力和选择性运动受损也应该在各种表现和整个生命周期中加以区分。尽管脑瘫是永久性的,但功能会随着生命周期的变化而变化,这表明干预措施对于改善与脑瘫相关的运动障碍的预后非常重要。越来越多的证据表明,包括主动监测、适应性体育活动和营养等多种干预措施,以预防继发性和三级并发症。未来研究的方向包括制定基于证据的建议、寻找现有疗法的低成本和高质量替代品,以确保普遍获得治疗、建立标准化的脑瘫登记处以协调流行病学和临床信息、改善成人筛查和检查计划以促进积极的生活体验,以及开展新干预措施的 3 期临床试验。

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