痉挛型双瘫脑瘫儿童粗大运动功能与脊柱活动度的相关性

doi:10.3969/j.issn.1006-9771.2022.10.012

《中国康复理论与实践》 ›› 2022, Vol. 28 ›› Issue (10): 1211-1216.doi: 10.3969/j.issn.1006-9771.2022.10.012

痉挛型双瘫脑瘫儿童粗大运动功能与脊柱活动度的相关性

李思佳^1,²,张琦^1,²(),何艳²,刘前进^1,²,张燕庆²,周天添^1,²

1.首都医科大学康复医学院,北京市 100068
2.中国康复研究中心北京博爱医院儿童物理疗法科,北京市 100068

收稿日期:2022-05-31 修回日期:2022-08-24 出版日期:2022-10-25 发布日期:2022-11-08
通讯作者: 张琦 E-mail:13501320729@163.com
作者简介:李思佳(1993-),女,朝鲜族,北京市人,硕士研究生,主管技师,主要研究方向：脑瘫、脊柱侧弯、脊髓损伤、脑卒中的物理治疗。
基金资助:
中国康复研究中心青年基金项目(2019ZX-Q5)

Correlation between gross motor function and spinal range of motion for children with bilateral spastic cerebral palsy

LI Sijia^1,²,ZHANG Qi^1,²(),HE Yan²,LIU Qianjin^1,²,ZHANG Yanqing²,ZHOU Tiantian^1,²

1. Capital Medical University School of Rehabilitation Medicine, Beijing 100068, China
2. Department of Physical Therapy, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing 100068, China

Received:2022-05-31 Revised:2022-08-24 Published:2022-10-25 Online:2022-11-08
Contact: ZHANG Qi E-mail:13501320729@163.com
Supported by:
Youth Fund of China Rehabilitation Research Center(2019ZX-Q5)

摘要/Abstract

摘要：

目的探讨痉挛型双瘫脑瘫儿童粗大运动功能与脊柱运动能力之间的关系。

方法选取2019年12月至2022年3月北京博爱医院痉挛型双瘫脑瘫儿童33例,按照粗大运动功能分级系统(GMFCS)分级,分为1组(Ⅰ级,n = 12)、2组(Ⅱ级,n = 11)和3组(Ⅲ级,n = 10)。采用SpinalMouse脊柱形态测量仪测量患儿坐位躯干前后屈、左右屈关节活动度。采用粗大运动功能测试(GMFM)88项进行测试。

结果后伸角度、矢状面总活动度、左屈角度、右屈角度、冠状面总活动度均与GMFM88评分呈正相关(r > 0.424, P < 0.05),与GMFCS分级呈负相关(|r| > 0.424, P < 0.05)。

结论痉挛型双瘫脑瘫儿童的脊柱活动度与粗大运动表现相关。

关键词: 痉挛型, 脑性瘫痪, 粗大运动功能, 脊柱, 关节活动度

Abstract:

Objective To explore the correlation between gross motor function and spinal range of motion (ROM) in children with bilateral spastic cerebral palsy.

Methods A total of 33 children with bilateral spastic cerebral palsy in Beijing Bo'ai Hospital from December, 2019 to March, 2022 were selected and divided into group 1 (grade Ⅰ, n = 12), group 2 (grade Ⅱ, n= 11) and group 3 (grade Ⅲ, n = 10) according to Gross Motor Function Classification System (GMFCS). SpinalMouse (spine morphometric machine) was used to measure the ROM of forward and backward flexion, and left and right lateral flexion of trunk, respectively, in sitting. Their gross motor ability was then further tested using the Gross Motor Function Measure (GMFM) 88 item.

Results The ROM of backward flexion, the left and right lateral flexion, and the total ROM of sagittal and coronal plane were positively correlated with the scores of GMFM88 (r > 0.424, P < 0.05), and were negatively correlated with the grade of GMFCS (|r| > 0.424, P < 0.05).

Conclusion Spinal ROM correlates with gross motor function in children with bilateral spastic cerebral palsy.

Key words: spastic, cerebral palsy, gross motor function, spine, range of motion

中图分类号:

R742.3

李思佳,张琦,何艳,刘前进,张燕庆,周天添. 痉挛型双瘫脑瘫儿童粗大运动功能与脊柱活动度的相关性[J]. 《中国康复理论与实践》, 2022, 28(10): 1211-1216.

LI Sijia,ZHANG Qi,HE Yan,LIU Qianjin,ZHANG Yanqing,ZHOU Tiantian. Correlation between gross motor function and spinal range of motion for children with bilateral spastic cerebral palsy[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(10): 1211-1216.

图/表 5

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参考文献 35

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组别	n	性别(男/女)/n	年龄/岁	身高/m	体质量/kg	BMI/kg·m^-2
1组	12	9/3	7.33±1.77	1.23±0.16	27.95±11.5	17.50±3.38
2组	11	7/4	7.09±1.86	1.16±0.14	26.75±7.69	19.87±5.89
3组	10	6/4	7.90±2.20	1.24±0.20	25.40±9.27	15.94±2.35
F值		0.620	0.462	0.659	0.188	2.368
P值		0.733	0.635	0.524	0.829	0.111

组别	n	前屈角度	后伸角度	矢状面总活动度
1组	12	91.83±16.48	15.98±5.62	107.81±15.63
2组	11	84.67±12.49	10.42 ±4.01	95.10±14.22
3组	10	79.33±14.43	11.00±3.52	90.33±12.99
F值		2.027	5.180	4.415
P值		0.149	0.012	0.021
P值^a		0.751	0.020	0.129
P值^b		0.166	0.048	0.024
P值^c		1.000	1.000	1.000

组别	n	左屈角度	右屈角度	冠状面总活动度
1组	12	25.05(17.90,27.45)	22.60(18.10,28.68)	47.65(35.70,56.05)
2组	11	20.00(12.50,23.00)	22.00(17.00,25.40)	39.50(36.30,48.00)
3组	10	15.40(13.53,17.38)	15.00(13.30,15.70)	28.95(27.30,33.00)
H值		9.920	11.248	12.464
P值		0.007	0.004	0.002
P值^a		0.484	1.000	1.000
P值^b		0.005	0.008	0.002
P值^c		0.242	0.013	0.027

组别	n	GMFM88评分
1组	12	257.00(253.75, 258.75)
2组	11	240.00(229.00, 243.00)
3组	10	182.00(149.50, 219.00)
H值		26.840
P值		< 0.001
P值^a		0.007
P值^b		< 0.001
P值^c		0.100

脊柱活动度	GMFM88评分		GMFCS分级
脊柱活动度	r值	P值	r值	P值
前屈角度	0.342	0.051	-0.277	0.118
后伸角度	0.424	0.014	-0.424	0.014
矢状面总活动度	0.506	0.003	-0.450	0.009
左屈角度	0.575	< 0.001	-0.554	0.001
右屈角度	0.510	0.002	-0.513	0.002
冠状面总活动度	0.584	< 0.001	-0.587	< 0.001

痉挛型双瘫脑瘫儿童粗大运动功能与脊柱活动度的相关性

Correlation between gross motor function and spinal range of motion for children with bilateral spastic cerebral palsy

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