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基于视频的动作观察训练和实际动作观察训练对痉挛性双瘫脑瘫儿童运动功能、活动参与及次要结局指标的影响:一项随机对照研究。

The Effect of Video-Based Action Observation Training and Live Action Observation Training on Motor Function, Activity Participation, and Secondary Outcome Measures in Children With Spastic Diparetic Cerebral Palsy: A Randomized Controlled Study.

机构信息

Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Igdir University, Iğdır, Turkey.

Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Inonu University, Malatya, Turkey.

出版信息

J Child Neurol. 2024 Nov;39(13-14):470-480. doi: 10.1177/08830738241280838. Epub 2024 Oct 8.

Abstract

BACKGROUND

This study aimed to investigate the effects of Video-Based Action Observation Training and Live Action Observation Training on motor function, activity participation, and secondary outcome measures in children with spastic diparetic cerebral palsy (CP).

MATERIALS AND METHODS

Thirty-nine children with spastic diparetic cerebral palsy, aged 5-14 years, with Gross Motor Function Classification System I-III, were distributed in equal numbers to any of the Video-Based Action Observation Training (conventional physiotherapy + Video-Based Action Observation Training), Live Action Observation Training (conventional physiotherapy + Live Action Observation Training), and control (conventional physiotherapy) groups through stratified randomization. For 8 weeks, action observation training groups received 20 minutes of conventional physiotherapy followed by 20 minutes of action observation training, and the control group received 40 minutes of conventional physiotherapy. Primary outcome measures were Gross Motor Function Measurement and Child and Adolescent Scale of Participation, secondary outcome measures were Pediatric Berg Balance Scale, timed-up-and-go test, five times sit-to-stand test (FTSST), Gillette Functional Assessment Questionnaire (GFAQ), and 1-minute walk test (1MWT).

RESULTS

Improvements were observed in all other evaluation parameters of the groups except Gross Motor Function Measurement-lying and rolling ( = .066) in the Live Action Observation Training Group, and lying and rolling ( = .317) and crawling and kneeling ( = .063) motor subtests and Gillette Functional Assessment Questionnaire-walking scale ( = .513) in the control group. Comparisons of the increases in all other measurements between the groups, except for the dimensions of Gross Motor Function Measurement-lying and rolling ( = .172), were statistically significant ( < .05) and this difference was in favor of action observation training.

CONCLUSION

It was found that 2 different AOTs applied in addition to conventional physiotherapy in children with spastic diparetic cerebral palsy were more effective on all outcomes than was conventional physiotherapy alone.

摘要

背景

本研究旨在探讨基于视频的动作观察训练和真人动作观察训练对痉挛性双瘫脑瘫儿童运动功能、活动参与和次要结果测量的影响。

材料和方法

39 名 5-14 岁痉挛性双瘫脑瘫儿童,粗大运动功能分类系统 I-III 级,通过分层随机分组等分为基于视频的动作观察训练组(常规物理治疗+基于视频的动作观察训练)、真人动作观察训练组(常规物理治疗+真人动作观察训练)和对照组(常规物理治疗)。8 周内,动作观察训练组接受 20 分钟常规物理治疗,然后进行 20 分钟动作观察训练,对照组接受 40 分钟常规物理治疗。主要结局测量指标为粗大运动功能测量和儿童青少年参与量表,次要结局测量指标为小儿伯格平衡量表、计时起坐试验、五次坐立试验(FTSST)、吉尔伯特功能评估问卷(GFAQ)和 1 分钟步行试验(1MWT)。

结果

除真人动作观察训练组的卧位和滚动运动( = .066)、对照组的卧位和滚动运动( = .317)和爬行和跪立运动( = .063)运动亚项以及吉尔伯特功能评估问卷-行走量表( = .513)外,所有其他评估参数均有改善。组间除粗大运动功能测量卧位和滚动运动( = .172)外,所有其他测量指标的增加均有统计学差异( < .05),且这一差异有利于动作观察训练。

结论

在痉挛性双瘫脑瘫儿童中,除常规物理治疗外,应用 2 种不同的 AOT 比单独应用常规物理治疗更能有效改善所有结局。

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