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光生物调节联合物理治疗对脊髓脊膜膨出患儿功能表现的影响——随机、盲法临床试验

Effect of Photobiomodulation Combined with Physiotherapy on Functional Performance in Children with Myelomeningo-Cele-Randomized, Blind, Clinical Trial.

作者信息

Silva Tamiris, Tobelem Daysi da Cruz, Malavazzi Tainá Caroline Dos Santos, Mendonça Juliana Fernandes Barreto de, Andreo Lucas, Chavantes Maria Cristina, Tempestini Horliana Anna Carolina Ratto, Turcio Karina Helga Leal, Gomes Andréa Oliver, Deana Alessandro Melo, Fernandes Kristianne Porta Santos, Motta Lara Jansiski, Mesquita-Ferrari Raquel Agnelli, Brugnera Aldo, Nammour Samir, Bussadori Sandra Kalil

机构信息

University Nove de Julho (UNINOVE), São Paulo 01525-000, SP, Brazil.

University of Canberra, Bruce, ACT 2617, Australia.

出版信息

J Clin Med. 2023 Apr 17;12(8):2920. doi: 10.3390/jcm12082920.

Abstract

BACKGROUND

This study aimed to evaluate the electrical activity of the rectus femoris, tibialis anterior, and lateral gastrocnemius muscles during the sit-to-stand task and functional mobility after a neurofunctional physiotherapy protocol associated with PBM.

METHODS

Twenty-five children were randomly allocated to either Active PBM + physiotherapy (n = 13) or PBM sham + physiotherapy (n = 12). PBM was carried out with a LED device (850 nm, 25 J, 50 s per point and 200 mW) at four points over the area with absence of a spiny process. Both groups completed a twelve-week supervised program with two weekly 45-60 min sessions. Pre-training and post-training assessments involved the Pediatric Evaluation of Disability Inventory (PEDI). Muscle activity was assessed using portable electromyography (BTS Engineering) and the electrodes were positioned on the lateral gastrocnemius, anterior tibialis, and rectus femoris muscles. The RMS data were recorded and analyzed.

RESULTS

After 24 sessions of the treatment protocol, improvements were found in the PEDI score. The participants presented greater independence in performing the tasks, requiring less assistance from their caregivers. More significant electrical activity was found in the three muscles evaluated between the rest period and execution of the sit-to-stand tasks, both in the more compromised or less compromised lower limbs.

CONCLUSION

Neurofunctional physiotherapy with or without PBM improved functional mobility and electrical muscle activity in children with myelomeningocele.

摘要

背景

本研究旨在评估在与低强度激光疗法(PBM)相关的神经功能物理治疗方案后,坐立任务期间股直肌、胫骨前肌和腓骨外侧肌的电活动以及功能活动能力。

方法

25名儿童被随机分配到主动PBM+物理治疗组(n = 13)或PBM假治疗+物理治疗组(n = 12)。使用LED设备(850纳米,25焦耳,每点50秒,200毫瓦)在无棘突区域的四个点进行PBM。两组均完成了一项为期12周的监督计划,每周进行两次,每次45 - 60分钟。训练前和训练后的评估包括儿童残疾评定量表(PEDI)。使用便携式肌电图(BTS工程公司)评估肌肉活动,电极放置在腓骨外侧肌、胫骨前肌和股直肌上。记录并分析均方根(RMS)数据。

结果

经过24次治疗方案后,PEDI评分有所改善。参与者在执行任务时表现出更大的独立性,需要照顾者的帮助更少。在休息期和坐立任务执行之间,在评估的三块肌肉中发现了更显著的电活动,无论是在受影响较大或较小的下肢。

结论

有或没有PBM的神经功能物理治疗均可改善脊髓脊膜膨出患儿的功能活动能力和肌肉电活动。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b116/10142114/d7c8cf60fa53/jcm-12-02920-g001.jpg

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