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小脑毛细胞星形细胞瘤切除术后患儿的双重任务训练对稳定性和功能的疗效:一项随机对照试验。

Efficacy of dual-task training on stability and function in children with ataxia after medulloblastoma resection: A randomized controlled trial.

机构信息

Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Dokki, Egypt.

Pediatric Oncology Department, National Cancer Institute, Cairo University and Children Cancer Hospital Egypt (CCHE-57357), Dokki, Egypt.

出版信息

Pediatr Blood Cancer. 2023 Nov;70(11):e30613. doi: 10.1002/pbc.30613. Epub 2023 Aug 10.

Abstract

BACKGROUND/OBJECTIVE: In children, medulloblastoma (MB) is the most prevalent posterior fossa tumor. The first line of treatment is maximal safe resection. Therefore, symptoms of ataxia are commonly seen. Training the brain on balance and cognitive tasks makes balance more automatic than without cognitive tasks. The goal was to assess the effectiveness of dual-task practice on balance after MB excision in children with ataxia.

METHODS

Thirty children with ataxia after MB resection at Children Cancer Hospital Egypt were randomized into two equal groups. Exercises for mobility, balance, and gait training were given to both groups. The research group underwent a specific dual-task program (balance and cognitive). The program ran 3 days per week for 8 weeks. Children were evaluated before and after the treatment regimen using the Scale of Assessment and Rating of Ataxia (SARA), the HUMAC Balance System, Pediatric Balance Scale, and Functional Independent Measurement. All children's legal guardians signed an ethical agreement.

RESULTS

A notable improvement in balance was found in the dual group in Pediatric Balance Scale (PBS) (p = .028) and stability test (p = .0001) in favor of the study group. No discernible difference was observed in the Functional Independent Measurement score among the two groups (p = .158), although there was a statistically significant increase in both groups after treatment.

CONCLUSION

Dual-task program is more effective than traditional physical therapy alone in improving balance in children with ataxia after MB resection.

摘要

背景/目的:在儿童中,髓母细胞瘤(MB)是最常见的后颅窝肿瘤。一线治疗方法是最大限度地安全切除。因此,通常会出现共济失调症状。在平衡和认知任务上训练大脑会使平衡比不进行认知任务更自动。目的是评估小脑共济失调儿童在 MB 切除术后进行双重任务练习对平衡的有效性。

方法

将 30 例埃及儿童癌症医院 MB 切除术后共济失调的儿童随机分为两组。两组均进行移动、平衡和步态训练练习。研究组进行特定的双重任务方案(平衡和认知)。该方案每周运行 3 天,持续 8 周。在治疗前和治疗后使用共济失调评估量表(SARA)、HUMAC 平衡系统、儿科平衡量表和功能独立性测量对所有儿童进行评估。所有儿童的法定监护人都签署了伦理协议。

结果

双重组在儿科平衡量表(PBS)(p = 0.028)和稳定性测试(p = 0.0001)中明显改善平衡,这对研究组有利。两组之间在功能独立性测量评分方面没有明显差异(p = 0.158),尽管两组在治疗后都有统计学意义上的增加。

结论

与单纯传统物理治疗相比,双重任务方案在改善 MB 切除术后共济失调儿童的平衡方面更有效。

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