目的 探讨动作观察疗法(AOT)对痉挛型脑瘫偏瘫患儿上肢功能的效果,及AOT的最佳治疗强度和治疗周期。方法 2017年3月至11月,将45例痉挛型脑瘫偏瘫患儿随机分为对照组和AOT组。对照组采用常规康复治疗并观看风景视频,分为A组和B组,A组(n=11)每次20 min,B组(n=13)每次30 min;AOT组在常规康复基础上辅以AOT,分为C组和D组,C组(n=10)每次20 min,D组(n=11)每次30 min;每周5次,共治疗12周。分别于治疗前、治疗8周、12周后对四组进行握力评定、Carroll上肢功能评定(UEFT)和儿童功能独立性评定(WeeFIM)。结果 治疗后,D组握力和UEFT评分优于B组和C组(P<0.05),C组优于A组(P<0.05);且12周的评定结果优于8周(P<0.05)。治疗8周、12周后,各组间WeeFIM量表评分无显著性差异(P>0.05)。结论 AOT可改善痉挛型脑瘫偏瘫患儿上肢运动功能。训练时间长,训练效果更佳。
Objective To explore the effect of action observation therapy (AOT) on upper limb function in children with spastic hemiplegic cerebral palsy, and the better program.Methods From March to November, 2017, 45 children with spastic hemiplegic cerebral palsy were randomly assigned to control group and AOT group. The control group was further divided into group A (n=11) and group B (n=11), and received conventional rehabilitation treatment and scenic-observation therapy, 20 minutes every time for group A, and 30 minutes every time for group B. AOT group was further divided into group C (n=10) and group D (n=11), and received AOT in addition, 20 minutes every time for group C, and 30 minutes every time for group D, five times each week for twelve weeks for all the groups. Before treatment, eight and twelve weeks after treatment, they were assessed with hand grip strength, Upper Extremities Functions Test (UEFT), and Wee Functional Independence Measure (WeeFIM).Results After treatment, the hand grip strength and the score of UEFT were better in group D than in groups B and C (P<0.05), and were better at twelve weeks than at eight weeks (P<0.05). No significant difference was found in the score of WeeFIM among groups after treatment (P>0.05).Conclusion AOT could improve upper limp function in children with spastic hemiplegic cerebral palsy, and it's more effective after more training.
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