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改良滑板疗法对脑瘫患儿躯干控制和髋部肌肉激活的影响——一项随机对照试验的初步研究。

Effect of modified scooter board therapy on trunk control and hip muscle activation in children with cerebral palsy - A pilot randomised control study.

作者信息

Karnad Shreekanth D, Narayan Amitesh, Kamath Nutan, Rao Bhamini Krishna, Sharma Monika, K Vijaya Kumar

机构信息

Department of Physiotherapy, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka 576104, India.

Department of Paediatrics, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka 576104, India.

出版信息

IBRO Neurosci Rep. 2025 Apr 19;18:705-713. doi: 10.1016/j.ibneur.2025.04.009. eCollection 2025 Jun.

Abstract

Cerebral palsy (CP), with an incidence rate of 2.95, is one of the leading causes of disability in children. The excessive tone in several muscle groups causes significant movement deficits and secondary impairments, such as hip displacement, affecting quality of life. Although age-related functional positioning treatment is effective, it does not prevent secondary deficits. Literature recommends the use of task-based training with an emphasis on the functional elongation of these spastic muscle groups. Thus, a therapy that is engaging, parent-inclusive, and addresses hip-related deficits is needed. Hence, this study aimed to develop and evaluate a therapy targeting adductor overactivity and trunk control. Modified Scooter Board Therapy (MSBT) is an intervention that uses a specially designed scooter board device, allowing children to propel themselves forward while positioned prone with hip abduction and neutral hip rotation. A convenient sample of eight children with CP were assigned to either the MSBT or conventional exercise group. The intervention lasted eight weeks, and electromyographic (EMG) recordings at rest and during volitional activity were obtained at baseline and after eight weeks. Non-parametric statistical analysis, with a significance level of p < 0.05, showed no statistically significant differences between the groups at the end of the eight weeks. However, volitional hip adductor activity significantly changed in the MSBT group, indicated by a reduction in mean motor unit potential at rest. Additionally, parents preferred MSBT for its ease of use. Thus, MSBT appears to be a clinically promising intervention to reduce adductor hypertonicity and improve active control, highlighting the importance of prone positioning with active elongation for better motor function.

摘要

脑瘫(CP)的发病率为2.95,是儿童致残的主要原因之一。多个肌肉群的肌张力过高会导致明显的运动缺陷和继发性损伤,如髋关节移位,影响生活质量。尽管与年龄相关的功能定位治疗有效,但它并不能预防继发性缺陷。文献推荐采用基于任务的训练,重点是这些痉挛性肌肉群的功能延长。因此,需要一种引人入胜、家长参与且能解决与髋关节相关缺陷的治疗方法。因此,本研究旨在开发和评估一种针对内收肌过度活动和躯干控制的治疗方法。改良滑板疗法(MSBT)是一种干预措施,它使用专门设计的滑板装置,让儿童在俯卧位且髋关节外展和中立位旋转的情况下向前推进自己。将八名脑瘫儿童的便利样本分配到MSBT组或传统运动组。干预持续八周,在基线和八周后获取静息和自主活动期间的肌电图(EMG)记录。非参数统计分析,显著性水平为p<0.05,结果显示八周结束时两组之间无统计学显著差异。然而,MSBT组的自主髋关节内收肌活动有显著变化,表现为静息时平均运动单位电位降低。此外,家长因MSBT使用方便而更喜欢它。因此,MSBT似乎是一种在临床上有前景的干预措施,可减少内收肌高张力并改善主动控制,突出了俯卧位主动伸展以获得更好运动功能的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8adf/12084500/56b8d8196eef/gr1.jpg

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