Steinbusch Catherine V M, Defesche Anke, van der Leij Bertie, Rameckers Eugene A A, Knijnenburg Annemarie C S, Vermeulen Jeroen R J, Janssen-Potten Yvonne J M
Adelante Rehabilitation Centre, 6301 KA Valkenburg, The Netherlands.
Research School CAPHRI, Department of Rehabilitation Medicine, Maastricht University, 6229 ER Maastricht, The Netherlands.
J Clin Med. 2023 Feb 17;12(4):1595. doi: 10.3390/jcm12041595.
(1) Background: Next to motor impairments, children with unilateral spastic cerebral palsy (CP) often experience sensory impairments. Intensive bimanual training is well known for improving motor abilities, though its effect on sensory impairments is less known. (2) Objective: To investigate whether bimanual intensive functional therapy without using enriched sensory materials improves somatosensory hand function. (3) Methods: A total of twenty-four participants with CP (12-17 years of age) received 80-90 h of intensive functional training aimed at improving bimanual performance in daily life. Somatosensory hand function was measured before training, directly after training, and at six months follow-up. Outcome measures were: proprioception, measured by thumb and wrist position tasks and thumb localization tasks; vibration sensation; tactile perception; and stereognosis. (4) Results: Next to improving on their individual treatment goals, after training, participants also showed significant improvements in the perception of thumb and wrist position, vibration sensation, tactile perception, and stereognosis of the more affected hand. Improvements were retained at six months follow-up. Conversely, proprioception measured by the thumb localization tasks did not improve after training. (5) Conclusions: Intensive functional bimanual training without environmental tactile enrichment may improve the somatosensory function of the more affected hand in children with unilateral spastic CP.
（1）背景：除运动障碍外，单侧痉挛性脑瘫（CP）患儿常伴有感觉障碍。强化双手训练以提高运动能力而闻名，但其对感觉障碍的影响尚鲜为人知。（2）目的：探讨不使用丰富感觉材料的双手强化功能疗法是否能改善手部体感功能。（3）方法：共有24名CP患儿（12 - 17岁）接受了80 - 90小时旨在改善日常生活中双手表现的强化功能训练。在训练前、训练结束后即刻以及随访6个月时测量手部体感功能。结果指标包括：通过拇指和腕部位置任务以及拇指定位任务测量的本体感觉；振动觉；触觉感知；以及实体觉。（4）结果：除了在各自的治疗目标上有所改善外，训练后，参与者在受影响更严重的手的拇指和腕部位置感知、振动觉、触觉感知和实体觉方面也有显著改善。这些改善在随访6个月时得以保持。相反，通过拇指定位任务测量的本体感觉在训练后没有改善。（5）结论：不进行环境触觉强化的强化双手功能训练可能会改善单侧痉挛性CP患儿受影响更严重的手的体感功能。
