儿童轮椅的临床应用研究进展

doi:10.3969/j.issn.1006-9771.2021.09.009

《中国康复理论与实践》 ›› 2021, Vol. 27 ›› Issue (9): 1059-1065.doi: 10.3969/j.issn.1006-9771.2021.09.009

儿童轮椅的临床应用研究进展

沈洁^1,²,周璇¹,杜青¹()

1.上海交通大学医学院附属新华医院康复医学科,上海市 200092
2.上海体育学院运动科学学院,上海市 200438

收稿日期:2020-06-11 修回日期:2021-06-12 出版日期:2021-09-25 发布日期:2021-10-09
通讯作者: 杜青 E-mail:duqing@xinhuamed.com.cn
作者简介:沈洁(1995-),女,汉族,浙江嘉兴市人,硕士研究生,主要研究方向：儿童康复。
基金资助:
"十四五"残疾人事业规划前期研究重点课题残疾人辅助器具领域研究课题(CJFJRRB03-2019);上海交通大学"交大之星"计划医工交叉研究基金项目(YG2019ZDA23);新华-渥太华临床研究国际合作项目(18JXO06)

Clinical Advance in Pediatric Wheelchair (review)

SHEN Jie^1,²,ZHOU Xuan¹,DU Qing¹()

1. Department of Rehabilitation Medicine, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200092, China
2. School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China

Received:2020-06-11 Revised:2021-06-12 Published:2021-09-25 Online:2021-10-09
Contact: DU Qing E-mail:duqing@xinhuamed.com.cn
Supported by:
Assistive Devices for Persons with Disabilities Research Program of "14th Five-Year Plan" Career Planning for Persons with Disabilities Key Research Program in Early-Stage(CJFJRRB03-2019);Medical Engineering Cross Research Fund of Shanghai Jiaotong University "Jiaotong Star Plan"(YG2019ZDA23);Xinhua-Ottawa Clinical Research International Cooperative Program(18JXO06)

摘要/Abstract

摘要：

目的系统综述儿童轮椅对残疾儿童的主要功能影响。方法检索PubMed、Web of Science、Embase、Cochrane Library、EBSCO (CINAHL)、中国知网、万方数据库、维普数据库建库至2021年2月儿童轮椅临床应用相关文献,对文献进行质量评价,并运用文献归纳法对儿童轮椅临床应用效果进行分析与提炼。结果共纳入10篇病例报道研究,1篇随机对照研究,1篇队列研究,文献质量评价显示较低。儿童轮椅适用于12月龄以上不同年龄段、不同疾病类型患儿,其中脑瘫儿童应用最为常见。儿童轮椅可提高残疾儿童的运动功能,促进认知功能发育,改善活动和参与能力。根据儿童个体状况,轮椅可个体化适配为手动轮椅、电动轮椅和智能轮椅三种类型,以附加体位支撑装置进行适应性改造。结论轮椅可用于改善残疾儿童功能和生活质量,虽功能康复效果已表现出良好趋势,但目前研究多数以病例报道为主,缺乏高质量临床对照,且尚未建立统一的适配标准。

关键词: 儿童, 辅助器具, 轮椅, 康复, 综述

Abstract:

Objective To systematically review the effectiveness of pediatric wheelchairs on the function of children with disabilities.Methods Literatures about clinical application of pediatric wheelchairs were researched from the PubMed, Web of Science, Embase, Cochrane Library, EBSCO (CINAHL), CNKI, Wanfang Database and VIP Database, till February, 2021. The clinical application effectiveness of pediatric wheelchairs was extracted and analyzed by inductive approach.Results A total of ten case studies, one randomized controlled study and one cohort study were included, and quality assessment showed low quality. There were different types of pediatric wheelchairs for all ages over twelve months and different disease types of children, mostly for cerebral palsy. The review showed that pediatric wheelchairs mainly improved the motor function of disabled children, promoted the development of cognitive functions, and improved activities and participation abilities. The wheelchairs could be individually adapted to manual wheelchairs, electric wheelchairs and smart wheelchairs, according to the individual conditions of the children, with additional postural support devices for adaptive transformation.Conclusion Pediatric wheelchairs can be used to improve the function and quality of life of children with disabilities. Although functional rehabilitation effects of pediatric wheelchairs have shown a promising trend, most of the current studies are case reports, and there is a lack of high-quality clinical control studies, and the unified adaptation standard has not been established yet.

Key words: children, assistive devices, wheelchair, rehabilitation, review

沈洁,周璇,杜青. 儿童轮椅的临床应用研究进展[J]. 《中国康复理论与实践》, 2021, 27(9): 1059-1065.

SHEN Jie,ZHOU Xuan,DU Qing. Clinical Advance in Pediatric Wheelchair (review)[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(9): 1059-1065.

图/表 3

图1

表1

纳入研究的基本特征"

研究	国家	研究类型	疾病类型(n)	年龄(岁)	轮椅类型	康复功能结局指标	轮椅参数
Jones等^[13](2012)	美国	随机对照研究	试验组：脑瘫(8)、侏儒症(1)、先天性肌病(1)、脑积水(1)、肌强直性营养不良(1)、四肢短肢畸形(1)、关节挛缩(1) 对照组：脑瘫(9)、先天性肌病(2)、第四脑室孔闭塞综合征(1)、发育不良(1)、早衰症(1)	1.8±0.4	电动轮椅	①巴特尔发展量表;②儿童生活功能量表;③早期适应量表	-
Rispin等^[14](2014)	美国	病例报道	脊柱裂/脑积水(13)、四肢先天性畸形(5)、骨质下降(2)、脑瘫(2)、马蹄内翻足(1)、肌营养不良(1)	10.5±2.2	手动轮椅	①六分钟移动距离;②“8”字环绕测试;③生理耗能指数	刚性轮椅架、后轮胎直径56 cm、宽5 cm
Ceres等^[15] (2005)	西班牙	病例报道	智力发育落后(5)	5.0±0.6	智能轮椅	①压力测试;②躲避障碍物测试	轮椅支架8 mm,坐垫承重60 kg
Cimolin等^[16] (2013)	意大利	病例报道	痉挛型双瘫(7)、痉挛型四肢瘫(10)、颅脑损伤(3)	7.0±2.4	手动轮椅	①坐位稳定性;②关节活动度：躯干屈曲、膝关节活动	座椅靠背角度 100°,腿踏板角度120°,2点/4点骨盆带
Rammer等^[17] (2019)	美国	病例报道	脊柱裂(4)、脑瘫(5)、腓骨肌萎缩症(1)	12.6±3.5	手动轮椅	①空间移动、轮椅推进测试;②关节活动度	-
Zhang等^[18] (2019)	加拿大	队列研究	健康儿童(26)	13.2±3.6	智能轮椅	①耐受性测试;②操作能力检查	-
Winkler等^[19] (2016)	美国	病例报道	脑瘫(1)、先天性心脏病(1)	-	智能轮椅	操作能力检查	-
Bottos等^[20] (2001)	意大利	病例报道	脑瘫(29)	3~8	电动轮椅	①雷特国际操作量表;②Peabody言语发育量表 ③粗大运动功能测试;④加拿大作业表现测量表;⑤Furumasu驾驶测试;⑥儿童疾病影响量表;⑦访谈	-
Meiser等^[21] (2007)	美国	病例报道	脊柱裂(2)	-	手动轮椅	①轮椅行进速度距离;②能量消耗指数;③感知疲劳程度;④接受度调查	-
Zondervan等^[22] (2015)	美国	病例报道	脑瘫(8)	-	智能轮椅	①反应力;②视觉空间感知	Kinect-轮椅接口控制改造
Vorster等^[23] (2019)	澳大利亚	病例报道	杜氏肌营养不良(12)	11.6±2.2	电动轮椅	①独立性;②身体活动;③情感情绪;④舒适与疲劳管理;⑤疼痛;⑥社会参与	-
McGarry等^[24] (2012)	澳大利亚	病例报道	脑瘫(4)	5~13	智能轮椅	①操作能力;②社会心理	-

表1

表2

参考文献 31

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儿童轮椅的临床应用研究进展

Clinical Advance in Pediatric Wheelchair (review)

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