《中国康复理论与实践》

中国康复理论与实践 >

2017 , Vol. 23 >Issue 10: 1117 - 1122

DOI: https://doi.org/10.3969/j.issn.1006-9771.2017.10.001

专题 ICF研究与应用

脑性瘫痪儿童功能特点分析与个别化康复策略设计——基于ICF-CY理论与方法

  • 杨桃 ,
  • 王国祥 ,
  • 邱卓英 ,
  • 黄珂 ,
  • 孙慧珍 ,
  • 殷荣宾
展开
  • 1.苏州大学体育学院,残疾功能评定与运动康复研究中心,江苏苏州市 215021;
    2.中国康复研究中心康复信息研究所,世界卫生组织国际分类家族中国合作中心,北京市 100068;
    3.中国智力和发展性残疾分级、评估和康复(运动)重点实验室,郑州大学,河南郑州市450001
杨桃(1994-),女,汉族,江苏宿迁市人,硕士研究生,主要研究方向：运动康复。

收稿日期: 2017-06-13

  修回日期: 2017-10-09

  网络出版日期: 2017-11-03

基金资助

中央级公益性科研院所基本科研业务费专项资金项目(重大科学研究引导基金项目)(No.2017CZ-7)

收起

Analysis of Functioning and Disability, and Design of Individualized Rehabilitation Strategies for Children with Cerebral Palsy Using ICF-CY

  • YANG Tao ,
  • WANG Guo-xiang ,
  • QIU Zhuo-ying ,
  • HUANG Ke ,
  • SUN Hui-zhen ,
  • YIN Rong-bin
Expand
  • 1. School of Physical Education and Sport Sciences, Research Center of Disability Evaluation and Sport Rehabilitation, Soochow University, Suzhou, Jiangsu 215021, China;
    2. Research Institute of Rehabilitation Information, China Rehabilitation Research Centre, WHO Family of International Classifications Collaborating Center in China, Beijing 100068, China;
    3. China Key Laboratory of Classification, Evaluation and Rehabilitation (Sport) of Intellectual and Developmental Disability, Zhengzhou University, Zhengzhou, Henan 450001, China

Received date: 2017-06-13

  Revised date: 2017-10-09

  Online published: 2017-11-03

Fold

摘要

目的 应用ICF-CY对脑瘫儿童主要功能障碍及康复策略进行系统研究。方法 使用脑性瘫痪ICF-CY的核心分类集,并综述相关文献,分析脑瘫儿童的身体结构和功能、活动和参与状况,特别是运动功能障碍。基于ICF-CY的理论架构,根据儿童发展的理论,探讨脑瘫儿童的康复策略。结果 脑瘫儿童主要功能障碍在身体结构和功能方面表现为脑结构的异常以及脑功能障碍,运动功能障碍;在活动和参与方面,认知、活动、自理等存在障碍,参与游戏、休闲和教育活动有局限,并受到环境因素的影响。脑瘫儿童的康复策略要从身体结构和功能、活动和参与以及环境因素考虑,制定符合个人特点的方案。结论 应用ICF-CY分析脑瘫儿童的功能障碍,构建个别化的康复策略,促进脑瘫儿童全面康复。

关键词： 脑性瘫痪; 功能状态; 康复策略; 国际功能、残疾和健康分类(儿童和青少年版)

本文引用格式

杨桃 , 王国祥 , 邱卓英 , 黄珂 , 孙慧珍 , 殷荣宾 . 脑性瘫痪儿童功能特点分析与个别化康复策略设计——基于ICF-CY理论与方法[J]. 中国康复理论与实践, 2017 , 23(10) : 1117 -1122 . DOI: 10.3969/j.issn.1006-9771.2017.10.001

Abstract

Objective To explore the functioning and disability and individualized rehabilitation strategies for children with cerebral palsy using ICF-CY.Methods ICF-CY core set for children with cerebral palsy was used, and literatures of functioning and disability (motor function) and physical activity and exercise rehabilitation for children with cerebral palsy were reviewed systematically. Based on the theoretical framework of ICF-CY and the theories of children's development, the rehabilitation strategies for children with cerebral palsy were discussed.Results The main functioning and disability for children with cerebral palsy were impairment of brain structure and nerve systemand motor function at body level; activity limitation and participation restriction in cognition, mobility and self-care, and restriction in participation in games, leisure and educational activities at individual level and related environmental factors. The rehabilitation strategies of children with cerebral palsy should be based on the physical structure and function, activities and participation, as well as environmental factors, to develop programs that met the characteristics of the individual.Conclusion The characteristics of functioning and disability for children with cerebral palsy were analyzed using ICF-CY. Individualized rehabilitation strategies should be developed to promote the overall developments for children with cerebral palsy.

Key words： cerebral palsy; functioning; rehabiliation strategies; International Classification of Functioning, Disability and Health-Children and Youth Version

参考文献

[1] Simeonsson RJ, Leonardi M, Bjorck-Akesson E, et al. Applying the International Classification of Functioning, Disability and Health to measure childhood disability [J]. Disabil Rehabil, 2003, 25(11): 602-610.
[2] Rosenbaum P, Paneth N, Leviton A, et al. A report: the definition and classification of cerebral palsy April 2006 [J]. Dev Med Child Neurol Suppl, 2007, 109: 8-14.
[3] 李晓捷,唐久来,马丙祥,等. 脑性瘫痪的定义、诊断标准及临床分型[J]. 实用儿科临床杂志, 2014, 29(19): 1520.
[4] 邱卓英,李欣,刘冯铂,等.基于ICF的智力残疾模式、测量方法及社会支持系统研究[J].中国康复理论与实践, 2016, 22(4): 373-377.
[5] Stucki G, Melvin J. 《国际功能、残疾和健康分类》：对物理和康复医学进行统一概念描述的模式[J]. 卢雯,李智玲,邱卓英,等,译. 中国康复理论与实践, 2008, 14(12): 1108-1111.
[6] Lee AM. Using the ICF-CY to organize characteristics of children's functioning [J]. Disabil Rehabil, 2011, 33(7): 605-616.
[7] 唐久来,秦炯,邹丽萍,等. 中国脑性瘫痪康复指南(2015)：第一部分[J]. 中国康复医学杂志, 2015, 30(7): 747-754.
[8] Reddihough D. Cerebral palsy in childhood [J]. Aust Fam Physician, 2011, 40(4): 192-196.
[9] Majnemer A, Shevell M, Hall N, et al. Developmental and functional abilities in children with cerebral palsy as related to pattern and level of motor function [J]. J Child Neurol, 2010, 25(10): 1236-1241.
[10] 李树春. 小儿脑性瘫痪[M]. 郑州:河南科学技术出版社, 2000: 31.
[11] Simeonsson RJ. Classifying functional manifestations of ectodermal dysplasias [J]. Am J Med Genet A, 2009, 149A(9): 2014-2019.
[12] Schiariti V, Klassen AF, Cieza A, et al. Comparing contents of outcome measures in cerebral palsy using the International Classification of Functioning (ICF-CY): a systematic review [J]. Eur J Paediatr Neurol, 2014, 18(1): 1-12.
[13] Schiariti V, Mâsse LC, Cieza A, et al. Toward the development of the International Classification of Functioning Core Sets for children with cerebral palsy: a global expert survey [J]. J Child Neurol, 2014, 29(5): 582-591.
[14] Schiariti V, Sauve K, Klassen AF, et al. 'He does not see himself as being different': the perspectives of children and caregivers on relevant areas of functioning in cerebral palsy [J]. Dev Med Child Neurol, 2014, 56(9): 853-861.
[15] Schiariti V, Selb M, Cieza A, et al. International Classification of Functioning, Disability and Health Core Sets for children and youth with cerebral palsy: a consensus meeting [J]. Dev Med Child Neurol, 2015, 57(2): 149-158.
[16] 邱卓英,李沁燚,陈迪,等. ICF-CY理论架构、方法、分类体系及其应用[J]. 中国康复理论与实践, 2014, 20(1): 1-5.
[17] 邱卓英,张爱民. 《国际功能、残疾和健康分类》应用指导(一)[J]. 中国康复理论与实践, 2003, 9(1): 20-33.
[18] Ballester-Planã J, Schmidt R, Laporta-Hoyos O, et al. Whole-brain structural connectivity in dyskinetic cerebral palsy and its association with motor and cognitive function [J]. Human Brain Mapp, 2017, 38(9): 4594-4612.
[19] Mailleux L, Klingels K, Fiori S, et al. How does the interaction of presumed timing, location and extent of the underlying brain lesion relate to upper limb function in children with unilateral cerebral palsy? [J]. Eur J Paediatr Neurol, 2017, 21(5): 763-772.
[20] Owen T, Adegboye D, Gimeno H, et al. Stable cognitive functioning with improved perceptual reasoning in children with dyskinetic cerebral palsy and other secondary dystonias after deep brain stimulation [J]. Eur J Paediatr Neurol, 2017, 21(1): 193-201.
[21] 世界卫生组织. 国际功能、残疾和健康分类(国际中文增补版)[M]. 邱卓英,译. 日内瓦:世界卫生组织, 2015: 110-117.
[22] 吕改玲,师红玲,刘媛媛. 脑瘫患儿头部控制障碍的康复治疗体会[J]. 中国医药指南, 2015, 13(15): 91-92.
[23] 曹春明,杜国志,李艳萍. 脑性瘫痪上肢畸形的康复疗效分析[J]. 中国康复医学杂志, 2006, 21(9): 839.
[24] Tsirikos AI. Cerebral palsy: classification, etiology and evolution of spine deformity in children and adolescents [J]. Curr Pediatr Rev, 2005, 1(2): 125-134.
[25] 廖元贵,吴毅,史惟,等. 痉挛型脑瘫患儿髋关节脱位的风险预测[J]. 中国康复理论与实践, 2009, 15(9): 825-826.
[26] 许晶莉,黄少昂,叶长青,等. 学龄期脑性瘫痪儿童髋关节发育与髋周肌肉状况的相关性分析[J]. 中国中西医结合儿科学, 2016, 8(1): 88-90.
[27] 龙亚君,丁玉莲,王跑球,等. 踝关节被动运动仪配合运动功能训练治疗痉挛型脑瘫患儿尖足疗效观察[J]. 中国康复医学杂志, 2014, 29(3): 272-273.
[28] Romkes J, Hell AK, Brunner R. Changes in muscle activity in children with hemiplegic cerebral palsy while walking with and without ankle-foot orthoses [J]. Gait Posture, 2006, 24(4): 467-474.
[29] Dursun E, Dursun N, Alican D. Ankle-foot orthoses: effect on gait in children with cerebral palsy [J]. Disabil Rehabil, 2002, 24(7): 345-347.
[30] Eek MN, Zügner R, Stefansdottir I, et al. Kinematic gait pattern in children with cerebral palsy and leg length discrepancy: Effects of an extra sole [J]. Gait Posture, 2017, 55: 150-156.
[31] 王宁,孙琳,邵翠霞,等. 步态分析在小儿脑性瘫痪诊疗和康复中的作用[J]. 山东医药, 2011, 51(24): 22-23.
[32] Peterson N, Walton R. Ambulant cerebral palsy [J]. Orthopaed Traum, 2016, 30(6): 525-538.
[33] Reid SM, Meehan E, Mc Intyre S, et al. Temporal trends in cerebral palsy by impairment severity and birth gestation [J]. Dev Med Child Neurol, 2016, 58(Suppl 2): 25-35.
[34] 张雁,胡莹媛,刘松怀. 脑性瘫痪患儿智力水平及智力结构的探讨[J]. 中华物理医学与康复杂志, 2005, 27(4): 238-240.
[35] 汤加利,史惟,郭金颖,等. 学龄期脑瘫患儿日常生活活动能力状况及影响因素分析[J]. 中国康复医学杂志, 2014, 29(6): 552-556.
[36] 杨杰,柳满燕,张燕君,等. 引导式教育对脑瘫儿童日常生活活动能力的疗效观察[J]. 中医儿科杂志, 2015, 11(2): 36-38.
[37] 王利平,兰继军. 智障儿童游戏研究进展[J]. 中国健康心理学杂志, 2011, 19(12): 1533-1535.
[38] Hwang S, Schneider ALJ, Clarke D, et al. How game balancing affects play: player adaptation in an exergame for children with cerebral palsy [C]. Conference on Designing Interactive Systems, ACM, 2017: 699-710.
[39] Majnemer A, Shevell M, Law M, et al. Participation and enjoyment of leisure activities in school-aged children with cerebral palsy [J]. Dev Med Child Neurol, 2008, 50(10): 751-758.
[40] Michelsen SI, Flachs EM, Damsgaard MT, et al. European study of frequency of participation of adolescents with and without cerebral palsy [J]. Eur J Paediatr Neurol, 2014, 18(3): 282-294.
[41] Law M, King G, King S, et al. Patterns of participation in recreational and leisure activities among children with complex physical disabilities [J]. Dev Med Child Neurol, 2006, 48(5): 337-342.
[42] 王和平. 脑瘫儿童入学前治疗、康复训练和教育状况调查[J]. 中国特殊教育, 2005(6): 16-19.
[43] 熊妮娜,王建文,陈耀红,等. 学龄期脑性瘫痪儿童康复、教育、辅具情况随访[J]. 中国康复理论与实践, 2017, 23(2): 237-241.
[44] Imms C, Wallen M, Elliott C, et al. Minimising impairment: Protocol for a multicentre randomised controlled trial of upper limb orthoses for children with cerebral palsy [J]. BMC Pediatr, 2016, 16(1): 1-15.
[45] 董理权,吴小高. 我国残疾人基本辅助器具服务保障制度建立的必要性浅析[J]. 中国康复理论与实践, 2016, 22(8): 989-992.
[46] Atkinson HL, Nixoncave K. A tool for clinical reasoning and reflection using the International Classification of Functioning, Disability and Health (ICF) framework and patient management model [J]. Phys Ther, 2011, 91(3): 416-430.
[47] 莫艳玲,杨锦媚,粟愿学,等. 现代信息技术在脑瘫儿童家庭康复训练指导中的应用研究[J]. 中国妇幼保健, 2016, 31(18): 3668-3670.
[48] 窦玉沛. 力推康复辅具业发展增进功能障碍人士福祉[J]. 社会福利, 2014(9): 4-5.
Options
文章导航

/

〈 〉