目的 探讨儿童爬行促通训练机器人治疗对痉挛型双瘫患儿的粗大运动功能及认知功能的影响。方法 选取2017年1月至12月本院痉挛型双瘫患儿60例,随机分为3组,每组20例。第Ⅰ组接受常规综合康复治疗及徒手爬行训练,第Ⅱ组在常规综合康复治疗基础上加用爬行架治疗,第Ⅲ组在常规综合康复治疗基础上加用儿童爬行促通训练机器人治疗。每天1次,每周5 d,共12周。治疗前后采用粗大运动功能测试量表-88项(GMFM-88量)评定患儿粗大运动发育情况,采用改良Ashworth量表(MAS)进行肌张力评定,采用Gesell发育量表中适应性发育商(DQ)进行认知功能评估。结果 治疗后,三组GMFM-88中总百分比及反映爬和跪的能区(C能区)百分比均显著改善(t>17.438, P<0.001),第Ⅱ组和第Ⅲ组优于第Ⅰ组(P<0.05),第Ⅲ组优于第Ⅱ组(P<0.05);三组MAS评分均改善(t>2.144, P<0.05),三组间比较无显著性差异(F=0.199, P>0.05);第Ⅱ组和第Ⅲ组GDS适应性DQ评分较治疗前均明显提高(t>3.040, P<0.001),第Ⅱ组和第Ⅲ组高于第Ⅰ组,第Ⅲ组高于第Ⅱ组(P<0.05)。结论 儿童爬行促通训练机器人能改善痉挛型双瘫儿童的粗大运动及认知功能,效果优于徒手爬行训练及爬行架训练。
Objective To observe the effects of Children's Crawling-Promotion-Training-Robot on gross motor function and cognitive function in children with spastic diplegia.Methods From January to December, 2017, 60 children with spastic diplegia were selected and randomly divided into three groups, with 20 cases in each group. All the groups received routine comprehensive rehabilitation therapy. In addition, group I received manual crawling training, group II was treated with crawler-training therapy, and group III was treated with Children's Crawling-Promotion-Training-Robot. They were treated ten minutes every day, five days a week for twelve weeks. Before and after treatment, the gross motor development, the muscle tension and cognitive function were evaluated with Gross Motor Function Measure Scale-88 (GMFM-88), modified Ashworth Scale (MAS) and developmental quotient (DQ) in Gesell Developmental Scale (GDS), respectively.Results After treatment, the overall percentage of GMFM-88 and the score of C dimension which were tightly tied to crawling and kneeling improved in all the groups (t>17.438, P<0.001), and the score was better in groups II and III than in group I (P<0.05), especially in group III (P<0.05); the score of MAS improved in all the groups (t>2.144, P<0.05), and no significant difference was found among them (F=0.199, P>0.05); the score of DQ in GDS improved in groups II and III (t>3.040, P<0.001), and the score was better in groups II and III than in group I (P<0.05), especially in group III (P<0.05).Conclusion Children's Crawling-Promotion-Training-Robot could improve the gross motor and cognitive function of children with spastic diplegia, which is better than manual crawling training and crawler-training.
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