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目的探讨手-臂双侧强化训练对痉挛型偏瘫脑瘫儿童上肢功能障碍及日常生活运动能力的影响,为脑瘫患儿的康复治疗提供依据。方法选取60例偏瘫型脑瘫儿童随机分为三组:试验A组(20例)、试验B组(20例)和对照组(20例)。对照组采用常规性OT治疗,试验组采用手-臂双侧徒手强化训练(HABIT)治疗,试验A、B组训练时间分别为每日0.5h、每日1h。三组分别于治疗前及治疗后8周、12周采用上肢功能评定量表(QUEST)、Peabody精细运动发育量(Peabody-FM)、儿童残疾评定量表(PEDI)进行评定和对比分析。结果三组儿童治疗后12周QUEST分数、PeabodyFM分数、PEDI分数均优于治疗前(P<0.05),试验A、B组均优于对照组(P<0.05),试验B组均优于试验A组(P<0.05);试验A、B各组组内对比,治疗后不同时长各项评分均有提高,治疗12周时各项评分与治疗8周时各项评分比较差异无统计学意义(P>0.05)。结论 HABIT治疗痉挛型偏瘫脑瘫儿童上肢功能障碍可有效提高儿童患手-臂的结构与功能、双手协作表现、日常生活活动能力,并且每日1h的HABIT训练较每日0.5h训练效果好,8周的治疗时间改善效果最为显著。
Objective To investigate the effect of hand-arm bilateral intensive training on upper extremity dysfunction and daily exercise capacity of spastic cerebral palsy children with cerebral palsy, and to provide basis for the rehabilitation of children with cerebral palsy. Methods Sixty children with hemiplegia were randomly divided into three groups: group A (20 cases), group B (20 cases) and control group (20 cases). The control group was treated with conventional OT. The experimental group was treated with hand-arm bilateral manual intensive training (HABIT). The training time in group A and group B was 0.5 h daily and 1 h daily. The three groups were assessed and compared with QUEST, Peabody-FM and PEDI before treatment, 8 weeks and 12 weeks after treatment. Results The QUEST score, PeabodyFM score and PEDI score of 12 weeks after treatment in both groups were better than those before treatment (P <0.05), and the scores in group A and B were better than those in control group (P <0.05) Group A (P <0.05). The scores of A, B in each group were significantly increased at different time points after treatment. There was no significant difference between each score and the 8th week after treatment (P> 0.05). Conclusion HABIT treatment of spastic hemiplegia cerebral palsy children with upper extremity dysfunction can effectively improve the hand-arm structure and function, hand coordination performance, activities of daily living, and 1h daily HABIT training than 0.5h daily training effect is good, 8 Week of treatment time to improve the effect of the most significant.