深层肌肉刺激对痉挛型脑瘫儿童肌肉结构和功能的效果

doi:10.3969/j.issn.1006-9771.2024.12.011

Abstract

Abstract:

Objective To observe the effect of deep muscle stimulation on muscle structure and function in children with spastic cerebral palsy.

Methods From January, 2023 to March, 2024, 30 children with spastic cerebral palsy in Beijing Bo'ai Hospital were randomly divided into control group (n = 15) and intervention group (n = 15). Both groups received conventional rehabilitation therapy, while the intervention group added deep muscle stimulation, for four weeks. Before and after training, the gastrocnemius muscle was examined by ultrasound diagnosis system in two aspects: transverse incision and longitudinal incision. Indicators included fascicle length, muscular thickness, cross sectional area and pennation angle. The modified Ashworth Scale (MAS) was used to assess the muscle tension of the lower extremity of the affected side. The standing, walking, running and jumping function were evaluated by Gross Motor Function Measure (GMFM) D and E areas.

Results After training, the fascicule length and pennation angle improved significantly in both groups (|t| > 6.329, P < 0.001), and they were better in the intervention group than in the control group (|t| > 2.347, P < 0.05); the scores of MAS decreased in both groups (t > 2.432, P < 0.05), and were better in the intervention group than in the control group (t = 2.140, P < 0.05); the scores of GMFM D and E areas significantly decreased in both groups (|t| > 8.473, P < 0.001), and were better in the intervention group than in the control group (|t| > 2.191, P < 0.05).

Conclusion Deep muscle stimulation could improve the fascicule length and pennation angle, and improve the spasticity and motor function of lower extremities in children with spastic cerebral palsy.

Key words: cerebral palsy, deep muscle stimulation, spasm, muscle structure

CLC Number:

R742.3

LIANG Yanhua, ZHANG Qi, HU Xiaoshi, LI Xiaosong, YUE Qing, ZHOU Tiantian, LI Sijia, FENG Amei. Effect of deep muscle stimulation on muscle structure and function in children with spastic cerebral palsy[J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(12): 1452-1460.

Figures/Tables 12

Table 1

Figure 1

Figure 2

Figure 3

Figure 4

Table 2

组别	n	测试	$x - ± s$	t值	P值
对照组	15	前测	33.36±5.15	-8.473	< 0.001
		后测	35.25±5.31
干预组	15	前测	35.16±3.93	-9.798	< 0.001
		后测	39.29±4.03
治疗前两组均值差			1.80±1.67	-1.076	0.291
治疗后两组均值差			4.04±1.72	-2.347	0.026

Table 2

Table 3

组别	n	测试	$x - ± s$	t值	P值
对照组	15	前测	15.47±1.25	9.539	< 0.001
		后测	14.60±1.18
干预组	15	前测	15.33±0.98	6.329	< 0.001
		后测	13.07±1.22
治疗前两组均值差			-0.13±0.41	0.326	0.747
治疗后两组均值差			-1.53±0.44	3.490	0.002

Table 3

Table 4

组别	n	测试	$x - ± s$	t值	P值
对照组	15	前测	7.07±0.76	0.587	0.567
		后测	7.05±0.74
干预组	15	前测	7.15±0.33	0.180	0.860
		后测	7.14±0.38
治疗前两组均值差			0.08±0.21	-0.376	0.710
治疗后两组均值差			0.09±0.21	-0.436	0.666

Table 4

Table 5

组别	n	测试	$x - ± s$	t值	P值
对照组	15	前测	1.72±0.41	-1.406	0.182
		后测	1.73±0.41
干预组	15	前测	1.88±0.53	0.746	0.468
		后测	1.87±0.53
治疗前两组均值差			0.16±0.17	-0.923	0.364
治疗后两组均值差			0.14±0.17	-0.782	0.441

Table 5

Table 6

Comparison of MAS scores in gastrocnemius muscle between two groups pre- and post-treatment"

组别	n	测试	$x - ± s$	t值	P值
对照组	15	前测	2.73±0.88	2.432	0.029
		后测	2.27±0.96
干预组	15	前测	2.67±0.98	8.500	< 0.001
		后测	1.53±0.92
治疗前两组均值差			-0.07±0.34	0.196	0.846
治疗后两组均值差			0.73±0.34	2.140	0.041

Table 6

Table 7

Comparison of GMFM D area scores between two groups pre- and post-treatment"

组别	n	测试	$x - ± s$	t值	P值
对照组	15	前测	30.40±3.16	-8.473	< 0.001
		后测	32.33±3.09
干预组	15	前测	31.27±2.76	-9.798	< 0.001
		后测	34.47±2.17
治疗前两组均值差			0.87±1.08	-0.800	0.431
治疗后两组均值差			2.13±0.97	-2.191	0.037

Table 7

Table 8

Comparison of GMFM E area scores between two groups pre- and post-treatment"

组别	n	测试	$x - ± s$	t值	P值
对照组	15	前测	40.67±11.08	-12.865	< 0.001
		后测	46.80±11.47
干预组	15	前测	45.47±9.50	-16.538	< 0.001
		后测	55.73±10.38
治疗前两组均值差			4.80±3.77	-1.274	0.213
治疗后两组均值差			8.93±3.99	-2.236	0.033

Table 8

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组别	n	性别(男/女)/n^a	年龄/岁^b	GMFCS分(I/II)/n^a
对照组	15	8/7	5.13±0.50	12/3
干预组	15	10/5	4.40±0.54	13/2
Z值		-	-1.503	-
P值		0.710	0.133	1.000

Effect of deep muscle stimulation on muscle structure and function in children with spastic cerebral palsy

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