基于中文版上肢技巧质量测试的改良强制性运动疗法对偏瘫型脑性瘫痪儿童上肢功能的效果

doi:10.3969/j.issn.1006-9771.2022.08.004

《中国康复理论与实践》 ›› 2022, Vol. 28 ›› Issue (8): 897-902.doi: 10.3969/j.issn.1006-9771.2022.08.004

• 专题儿童与青少年功能康复 • 上一篇下一篇

基于中文版上肢技巧质量测试的改良强制性运动疗法对偏瘫型脑性瘫痪儿童上肢功能的效果

刘鹏^1,²,苏春¹,邵磊²,贾梦怡¹,王海侠¹,田斯辕¹,耿开晴¹,张亚男²()

1.徐州市康复医院/徐州医科大学附属徐州康复医院,江苏徐州市 221010
2.徐州市中心医院康复医学科/徐州医科大学徐州临床学院,江苏徐州市 221009

收稿日期:2022-01-17 修回日期:2022-06-28 出版日期:2022-08-25 发布日期:2022-08-30
通讯作者: 张亚男 E-mail:634125937@qq.com
作者简介:刘鹏(1984-),男,汉族,黑龙江绥化市人,硕士,副主任医师,主要研究方向：脑性瘫痪等儿童发育障碍性疾病的康复。
基金资助:
徐州市卫生健康委科技项目(XWKYHT20200007)

Effect of modified constraint-induced movement therapy based on Chinese version of Quality of Upper Extremity Skills Test on upper limb function for children with hemiplegic cerebral palsy

LIU Peng^1,²,SU Chun¹,SHAO Lei²,JIA Mengyi¹,WANG Haixia¹,TIAN Siyuan¹,GENG Kaiqing¹,ZHANG Yanan²()

1. Xuzhou Rehabilitation Hospital, the Affiliated Xuzhou Rehabilitation Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221010, China
2. Xuzhou Central Hospital, Xuzhou Clinical College of Xuzhou Medical University, Xuzhou, Jiangsu 221009, China

Received:2022-01-17 Revised:2022-06-28 Published:2022-08-25 Online:2022-08-30
Contact: ZHANG Yanan E-mail:634125937@qq.com
Supported by:
Technology Project of Xuzhou Health Commission(XWKYHT20200007)

摘要/Abstract

摘要：

目的探讨基于中文版上肢技巧质量测试(Ch-QUEST)的改良强制性运动疗法(mCIMT)对偏瘫型脑瘫儿童上肢功能的影响。

方法选取2021年1月至11月在徐州市康复医院儿童康复科门诊治疗的40例偏瘫型脑瘫儿童,随机分为对照组(n = 20)和观察组(n = 20)。对照组进行常规上肢功能训练,观察组在此基础上增加基于Ch-QUEST的mCIMT,共12周。治疗前后采用Ch-QUEST、Peabody精细运动发育量表(PDMS-FM)和儿童功能独立性评定量表(WeeFIM)进行评定。

结果治疗后,两组Ch-QUEST评分、PDMS-FM原始分评分、WeeFIM评分均较治疗前明显提高(|t| > 3.432, P < 0.01),且观察组各评分均优于对照组(t > 2.032, P < 0.05)。

结论基于Ch-QUEST的mCIMT可改善偏瘫型脑瘫儿童上肢功能。

关键词: 脑性瘫痪, 改良强制性运动疗法, 中文版上肢技巧质量测试, 上肢功能

Abstract:

Objective To explore the effect of modified constraint-induced movement therapy (mCIMT) based on Chinese version of Quality of Upper Extremity Skills Test (Ch-QUEST) on upper limb function in children with hemiplegic cerebral palsy.

Methods From January to November, 2021, 40 children with hemiplegic cerebral palsy in Xuzhou Rehabilitation Hospital were recruited and randomly divided into control group (n= 20) and observation group (n= 20). The control group received routine upper limb function training, and the observation group received mCIMT based on Ch-QUEST additionally, for twelve weeks. They were assessed with Ch-QUEST, Peabody Developmental Motor Scale-Fine Motor (PDMS-FM) and Function Independence Measure for Children (WeeFIM) before and after treatment.

Results After treatment, the scores of Ch-QUEST, DMS-FM (raw score) and WeeFIM significantly increased in both groups (|t| > 3.432, P< 0.01), and were higher in the observation group than in the control group (t > 2.032, P < 0.05).

Conclusion mCIMT based on Ch-QUEST could improve the upper limb function of children with hemiplegic cerebral palsy.

Key words: cerebral palsy, modified constraint-induced movement therapy, Chinese version of Quality of Upper Extremity Skills Test, upper limb function

中图分类号:

R742.3

刘鹏,苏春,邵磊,贾梦怡,王海侠,田斯辕,耿开晴,张亚男. 基于中文版上肢技巧质量测试的改良强制性运动疗法对偏瘫型脑性瘫痪儿童上肢功能的效果[J]. 《中国康复理论与实践》, 2022, 28(8): 897-902.

LIU Peng,SU Chun,SHAO Lei,JIA Mengyi,WANG Haixia,TIAN Siyuan,GENG Kaiqing,ZHANG Yanan. Effect of modified constraint-induced movement therapy based on Chinese version of Quality of Upper Extremity Skills Test on upper limb function for children with hemiplegic cerebral palsy[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(8): 897-902.

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组别	n	性别/n		年龄/岁	偏瘫侧/n
组别	n	男	女	年龄/岁	左	右
对照组	20	11	9	3.04±0.86	11	9
观察组	20	12	8	2.94±0.88	8	12
χ²/t值		0.102		0.33	0.902
P值		0.749		0.75	0.342

项目	示范动作
肩部	伸出上肢够取玩偶、触碰水泡泡等
肘部	击掌、把积木放在儿童手中、在手掌上贴纸画等
腕部	把玩具放在前臂末端,让儿童屈腕触摸等
手指	假装弹钢琴、手指敲桌子模拟下雨的声音、手模仿蜘蛛等
抓握	假装拿烫的鸡蛋、儿童拿秘密的玩具给你看(手掌向上)等

组别	n	治疗前	治疗后	t值	P值
对照组	20	44.8±15.1	48.7±15.3	-10.996	< 0.001
观察组	20	43.9±14.3	58.1±14.1	-26.017	< 0.001
t值		-0.183	2.032
P值		0.856	0.049

组别	n	治疗前	治疗后	t值	P值
对照组	20	117.1±20.6	121.4±23.3	-3.432	0.003
观察组	20	116.0±19.3	137.2±22.4	-18.730	< 0.001
t值		-0.175	2.184
P值		0.862	0.035

组别	n	治疗前	治疗后	t值	P值
对照组	20	50.0±14.4	56.9±12.8	-8.613	< 0.001
观察组	20	49.8±13.0	67.0±14.2	-16.348	< 0.001
t值		-0.058	2.360
P值		0.950	0.024

基于中文版上肢技巧质量测试的改良强制性运动疗法对偏瘫型脑性瘫痪儿童上肢功能的效果

Effect of modified constraint-induced movement therapy based on Chinese version of Quality of Upper Extremity Skills Test on upper limb function for children with hemiplegic cerebral palsy

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