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青少年和成人脑瘫患者运动结局的相关因素:一项系统综述。

Factors related to motor outcomes in adolescents and adults with cerebral palsy: A systematic review.

作者信息

Félix Lôbo Monteiro Rayane, Santana Camila Araújo Santos, Chagas Paula Silva de Carvalho, de Campos Ana Carolina

机构信息

Universidade Federal de São Carlos, São Carlos, SP, Brazil.

Universidade Federal de São Carlos, São Carlos, SP, Brazil.

出版信息

Braz J Phys Ther. 2025 May 31;29(5):101225. doi: 10.1016/j.bjpt.2025.101225.

Abstract

BACKGROUND

Although the brain injury caused by cerebral palsy (CP) is not progressive, there is often a worsening of physical conditions during the transition to adolescence and adulthood. The aim of this systematic review was to summarize factors related to decline in motor function in adolescents and adults with CP.

METHODS

This review was registered in PROSPERO (CRD42022311783). Studies met the following criteria: participants diagnosed with CP, ages 10 to 59 years; scientific studies with any methodological design and emphasis on motor function, reporting quantitative analysis of the effect of age on motor function or factors relevant that declined or improved motor capacity; published in English; any publication year, in electronic databases: Pubmed/Medline, Scopus, Cinahl. Data selection and extraction used the Covidence software. Factors related to motor outcomes that were statistically significant in at least one study and present in more than one study were reported. The outcomes were grouped within major categories (gross motor function, neuromusculoskeletal functions, and gait) for summary.

RESULTS

23 studies met the inclusion criteria. Relevant factors for changes in gross motor function (n = 16 studies) were: pain, neuromusculoskeletal aspects, altered gait parameters, Gross Motor Function Classification System (GMFCS) level, age, and history of surgery; for gait (n = 11): mobility performance, altered gait parameters, age, GMFCS level, pain and neuromusculoskeletal aspects; and for neuromusculoskeletal functions (n = 4): altered gait parameters, neuromusculoskeletal aspects, age, pain, and GMFCS level.

CONCLUSION

Age, GMFCS level, and presence of pain stood out as significant for motor decline across categories. Monitoring these factors is relevant for planning interventions and transition programs.

摘要

背景

尽管脑瘫(CP)所致脑损伤并非进行性的,但在向青少年期和成年期过渡过程中,身体状况往往会恶化。本系统评价的目的是总结与CP青少年和成人运动功能下降相关的因素。

方法

本评价已在国际前瞻性系统评价注册库(PROSPERO,注册号:CRD42022311783)登记。纳入研究符合以下标准:参与者诊断为CP,年龄10至59岁;采用任何方法设计且侧重于运动功能的科学研究,报告年龄对运动功能影响的定量分析或与运动能力下降或改善相关的因素;以英文发表;发表年份不限,来自电子数据库:PubMed/Medline、Scopus、CINAHL。数据选择和提取使用Covidence软件。报告了在至少一项研究中具有统计学意义且在多项研究中出现的与运动结果相关的因素。结果按主要类别(粗大运动功能、神经肌肉骨骼功能和步态)分组进行总结。

结果

23项研究符合纳入标准。粗大运动功能变化的相关因素(n = 16项研究)为:疼痛、神经肌肉骨骼方面、步态参数改变、粗大运动功能分类系统(GMFCS)水平、年龄和手术史;步态方面(n = 11项研究)为:活动能力表现、步态参数改变、年龄、GMFCS水平、疼痛和神经肌肉骨骼方面;神经肌肉骨骼功能方面(n = 4项研究)为:步态参数改变、神经肌肉骨骼方面、年龄、疼痛和GMFCS水平。

结论

年龄、GMFCS水平和疼痛的存在在各类别中均显示为运动功能下降的显著因素。监测这些因素对于规划干预措施和过渡计划具有重要意义。

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