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目的研究引导式教育疗法对脑性瘫痪(CP)患儿粗大运动功能和日常生活活动能力(ADL)的康复疗效。方法将233例首次就诊的12月龄以上的CP患儿按照治疗方法的不同分为2组:以引导式教育+Bobath疗法治疗者为研究组(94例),选同期单用Bobath疗法治疗的CP患儿为对照组(139例)。将研究组与对照组治疗前后粗大运动功能量表88项(GMFM-88)和ADL评分及评分差值分别进行比较。结果研究组与对照组治疗前GMFM-88评分比较差异无统计学意义(t=0.610,P>0.05);2组治疗前后的GMFM-88评分差值比较差异有统计学意义(t=2.277,P<0.05);1～3岁组治疗前后的GMFM-88评分差值在研究组和对照组间差异有统计学意义(P<0.05)。研究组和对照组治疗后GMFM-88评分均显著高于治疗前(t=25.301、18.348,Pa<0.01)。研究组与对照组治疗前ADL评分比较差异无统计学意义(t=1.968,P>0.05);2组治疗后ADL评分均显著高于治疗前(t=11.585、15.249,Pa<0.01);研究组和对照组治疗前后ADL评分差值比较差异有统计学意义(t=7.593,P<0.01)。各年龄组治疗前后的ADL评分差值在研究组和对照组间差异均有统计学意义(Pa<0.01)。结论引导式教育+Bobath疗法及单用Bobath疗法均能提高CP患儿的粗大运动功能和ADL,引导式教育+Bobath疗法联合应用的疗效显著优于单用Bobath疗法。引导式教育疗法能显著提高CP患儿的粗大运动功能和ADL。
Objective To study the effect of guided education on rehabilitation of gross motor function and daily living activity (ADL) in children with cerebral palsy (CP). Methods A total of 233 first-visit CP patients aged 12 months and older were divided into two groups according to the different treatment methods: guided education + Bobath therapy group (n = 94), and concurrent treatment with Bobath alone CP children as control group (139 cases). The study group and control group before and after treatment of gross motor function scale 88 (GMFM-88) and ADL score and score difference were compared. Results There was no significant difference in GMFM-88 score between the two groups before and after treatment (t = 0.610, P> 0.05). There was significant difference in GMFM-88 score between the two groups before and after treatment (t = 2.277, P <0.05). The difference of GMFM-88 score before and after treatment in the 1 to 3 years old group was statistically significant (P <0.05) between the study group and the control group. The GMFM-88 scores of the study group and the control group after treatment were significantly higher than those before treatment (t = 25.301, 18.348, Pa <0.01). There was no significant difference in ADL score between study group and control group before treatment (t = 1.968, P> 0.05). The ADL scores of two groups were significantly higher than those before treatment (t = 11.585,15.249, Pa0.01) There was significant difference in ADL score between the two groups before and after treatment (t = 7.593, P <0.01). The difference of ADL score between before and after treatment in each age group was statistically significant (P <0.01) between study group and control group. Conclusions Guided education + Bobath therapy and Bobath therapy alone can both improve the gross motor function and ADL in children with CP. The combination of guided education and Bobath therapy is superior to Bobath alone. Guided education can significantly improve CP in children with gross motor function and ADL.