Objective To observe the effects of aerobic exercise in an enriched environment on restricted repetitive behaviors(RRBs)and working memory in children with autism spectrum disorder(ASD).Methods A total of 62 children with ASD who vis-ited the Department of Rehabilitation of Children's Hospital of Soochow University from May to December 2022 were selected as the research subjects.Using the random number table sampling method,these children were randomly divided into control group(n=31)and observation group(n=31).Both the two groups underwent routine rehabilitation training;in addition,the control group participated in group indoor walking activities,and the observation group engaged in group indoor obstacle-crossing running as a form of aerobic exercise,with the indoor environment being changed once a week.The exercises were performed for 15 minutes per session,twice a day,5 days a week for 15 weeks.The repetitive behavior scale-revised(RBS-R)was used before and after treatment to assess RRBs,and the fourth edition of the Webster Preschool and Primary Scale of Intelligence/Wechsler Intelligence Scale for Children(WPPSI/WISC-Ⅳ)were used for working memory assessment.Results After 15 weeks of treatment,the total score of RBS-R in the control group was significantly lower than that before treatment,and the difference was statistically significant(P<0.05).The observation group showed significant reductions in stereotyped behavior,compulsive behavior and total score com-pared to those before treatment,and the differences were statistically significant(P<0.05,P<0.01).When comparing the two groups,the total RBS-R score in the observation group was significantly lower than that in the control group,and the difference was statisti-cally significant(P<0.05).The working memory score of WPPSI/WISC-Ⅳ in the observation group significantly improved com-pared with that before treatment(P<0.05),and there was no significant change in the control group compared with before treatment.At 4 weeks after the aerobic exercise intervention was discontinued,the RBS-R scores in the observation group further reduced compared with the scores at the 15 weeks of the intervention,and the differences were statistically significant(P<0.05).Conclu-sion Aerobic exercise in an enriched environment can reduce RRBs in children with ASD and improve working memory,and the reduction of RRBs in children with ASD can be sustained after the cessation of aerobic exercise.

Objective:To observe the effect of repetitive transcranial magnetic stimulation(rTMS)combined with local vibra-tion(LVB)therapy on lower limb spasticity,balance function and gait function in children with hemiplegic cerebral palsy(HCP).Methods:A total of 66 children with HCP,who were treated in the Children's Hospital of Soochow University from January 2022 to December 2022 were randomly divided into control group,rTMS group and combined group,with 22 cases in each group.The control group received routine rehabilitation training(physical modality therapy,spasmodic muscle stretching training,postural transfer training,standing blance training and gait training,etc),30 minutes a time,once a day,five days a week,lasting for twelve weeks.The rTMS group received low-frequency rTMS treatment additionally,with a frequency of five Hz and a stimulation intensity of 35%motor threshold(MT),the stimulation time of 10 s,and the interval of 20 s,20 minutes a time,once a day,five days a week,lasting for 12 weeks.The combined group received LVB therapy in addition to the treatment of the rTMS group,and the vibration frequency was set to 15-20 Hz,within seven mm displacement,10 minutes a time,once a day,five days a week,lasting for 12 weeks.Before and after treatment,the modified Ashworth scale(MAS)was used to evaluate the muscle tone;the balance subscale of Fugl-Meyer test(FM-B)was used to evaluate the balance function,and the Gait Watch three-dimensional gait analysis system was used to evaluate the three-dimensional gait parameters(stride speed,stride length,hip flexion,knee flexion and ankle flexion of the affected side).Results:Compared with that before treatment,MAS scores of the rTMS group and the combined group after treat-ment decreased significantly,the FM-B scores and gait parameters(stride speed,stride length,hip flexion,knee flexion and ankle flexion of the affected side)increased significantly,and the differences were statistically significant(P<0.05).Compared with the control group,MAS scores of the rTMS group and the combined group after treatment decreased significantly,FM-B score,stride length and stride speed increased significantly(P<0.05);compared with the rTMS group,MAS score of the combined group after treatment decreased significantly,FM-B score and gait parameters(stride speed,stride length,hip flexion,knee flexion and ankle flexion of the affected side)increased significantly,and the differences were statistically significant(P<0.05).Conclusion:The rT-MS combined with LVB therapy can effectively improve the lower limb spasticity,balance function and gait function of children with HCP,which is recommended for clinical application.

目的 观察有氧运动对注意缺陷多动障碍(ADHD)儿童核心症状和执行功能的影响.方法 2020年6月至2021年12月,独墅湖医院门诊ADHD患儿64例,随机分为对照组(n=32)和观察组(n=32).对照组静坐观看动画片20 min,观察组在看动画片的同时进行骑车运动训练,共12周.训练前后采用Conners父母用症状问卷(PSQ)进行核心症状评估,采用心理学测试软件E-Prime 2.0系统进行抑制、转换、刷新功能的评估.结果 治疗后,观察组PSQ各因子评分均显著下降(t>4.775,P<0.001),且明显低于对照组(t>3.184,P<0.01);观察组抑制、转换和刷新功能的反应时和精确度均下降(t>2.259,P<0.05),且均低于对照组(t>2.007,P<0.05).结论 有氧运动可减轻ADHD儿童注意力差和多动冲动的核心症状,提高执行功能.

目的 探讨重复经颅磁刺激联合感觉统合训练治疗注意缺陷多动障碍(ADHD)儿童的临床效果.方法 选择2019年10月—2021年9月本院收治的69例ADHD患儿作为研究对象,采用随机数表法分为感觉统合(SI)组、重复经颅磁刺激(rTMS)组和联合组,每组各23例.SI组给予针对性的感觉统合训练,rTMS组以10Hz高频刺激右侧背外侧前额叶皮质,联合组先进行SI训练,随后以rTMS刺激.三组治疗持续12周.治疗前后以Conners父母用症状问卷(PSQ),中文版斯诺佩第4版评估量表(SNAP-Ⅳ)和视听整合持续操作测试(IVA-CPT)进行疗效评估.结果 治疗12周后,三组患儿PSQ评分和SNAP-Ⅳ评分各因子分较治疗前均显著下降,差异有统计学意义(P<0.05),联合组各因子分均优于SI组和rTMS组,差异有统计学意义(P<0.05),而SI组和rTMS组间比较,差异无统计学意义(P>0.05).IVA-CPT评分较治疗前显著提升,联合组各因子分均优于SI组和rTMS组,差异有统计学意义(P<0.05).SI组和rTMS组间比较,差异无统计学意义(P>0.05).结论 重复经颅磁刺激联合感觉统合训练可显著改善ADHD儿童的核心症状,提高抑制控制能力,增强注意力水平,且效果优于单一疗法.

Objective:To explore the effect of combining repetitive transcranial magnetic stimulation (rTMS) with constraint-induced movement therapy (CIMT) in rehabilitating the upper limb functioning of children with hemiplegic cerebral palsy.Methods:Sixty children with hemiplegic cerebral palsy were recruited and randomly divided into a control group ( n=30) and an experimental group ( n=30). Both groups were given conventional rehabilitation therapy and intensive one-to-one CIMT of the affected hand for 30 minutes 5 times a week for 4 successive weeks. The healthy hand was immobilized in a hand cushion for 3 hours. The experimental group was additionally provided with 20 minutes of rTMS at 1.0Hz, 5 times a week for the same 4 weeks. Before and after the treatment, both groups were evaluated using the Peabody Developmental Motor Scales (PDMS-2 FM) and an upper extremities function test (UEFT). Results:After 4 weeks of treatment there was significant improvement in both groups with regard to the average PDMS-2 FM and UEFT scores. The improvement in the experimental group was significantly better.Conclusions:rTMS combined with CIMT can effectively improve upper limb motor function and promote the fine motor development of children with hemiplegic cerebral palsy.

目的:观察重复性外周磁刺激联合口部运动治疗对脑瘫患儿口咽期吞咽功能障碍的影响.方法:将60例口咽期吞咽障碍脑瘫患儿随机分为观察组和对照组,每组30例.2组患儿均给予常规口部运动治疗,观察组患儿在此基础上辅以重复性外周磁刺激治疗,治疗6周.采用临床疗效评价,吞咽障碍评价(DDS)及吞咽障碍分级标准(VFSS)评定2组患儿吞咽功能改善情况.结果:治疗后,观察组患儿临床治疗总有效率显著高于对照组(分别为96.7％、66.6％,P＜0.05).治疗后,2组患儿DDS评分均较治疗前明显降低(P＜0.05,0.01),且观察组明显低于对照组(P＜0.05);2组患儿VFSS评分均较治疗前明显上升(P＜0.05,0.01),且观察组明显高于对照组(P＜0.05).结论:重复性外周磁刺激联合口部运动治疗能明显改善脑瘫患儿口咽期吞咽功能障碍,其疗效优于单纯口部运动治疗,该联合疗法值得在脑瘫患儿吞咽障碍患儿中推广、应用.

目的:针对痉挛型脑瘫患儿探究以重复经颅磁刺激(rTMS)展开治疗后,患儿痉挛和运动功能的影响.方法:数字表随机选择2017年10月-2018年10月收治的在我院确诊为痉挛型脑瘫患儿共计83例,选择20例为对照组展开我院常规康复治疗措施,剩余63例为观察组选择常规康复治疗措施联合重复经颅磁刺激展开治疗.探究2组患儿在痉挛和运动功能上的表现.结果:痉挛程度上,2组均未出现0级和4级,但观察组和对照组未见显著差异(P>0.05);粗大运动功能:观察组得分(85.8±2.7)分,对照组得分(59.8±9.8)分,观察组明显高于对照组,差异显著,P<0.05.患儿治疗前后踝关节活动度对比:治疗前2组患儿均未出现显著差异,P>0.05;治疗后观察组的踝关节活动度明显高于对照组,显著差异,P<0.05.并发症发生情况上,2组患儿均未出现严重并发症.结论:痉挛型脑瘫患儿选择重复经颅磁刺激治疗痉挛和运功功能效果显著,相对更加安全,关节活动度更高,值得在临床上推广.

Objective To observe the effect of speech therapy in group on children with autism spectrum disorders(ASD). Methods From July,2014 to July,2015,60 children with ASD were randomly divided into control group(n=30)and ex-perimental group(n=30).Both groups accepted regular rehabilitation training,while the experimental group ac-cepted speech therapy in group in addition,for six months.They were assessed with Autism Behavior Checklist (ABC)and Autism Treatment Evaluation Checklist(ATEC)before and after training,. Results The scores of ABC in both groups decreased after training(t>3.079,P<0.01),and decreased more in the experi-mental group(t=3.149,P<0.01).The score of Health/Physical/Behavior and total score of ATEC decreased in the control group(t>3.018,P<0.01),while the scores of all the items of ATEC decreased in the experimental group (t>2.498,P<0.05)after treatment.The scores of all the items of ATEC decreased more in the experimental group than in the control group(t>2.027,P<0.05). Conclusion The addition of speech therapy in group can further improve the behavior in children with ASD.

Objective To investigate the effect of small muscle learning on children with autism spectrum disorders (ASD). Methods From August, 2014 to June, 2015, 40 children of three to six years old with ASD were randomly divided into experimental group (n=20) and control group (n=20). Both groups accepted structured teaching, while the experimental group accepted small muscle learning in addition. They were assessed with Autism Treatment Evaluation Checklist (ATEC) and Psychoeducational Profile Third Edition (PEP-3) before and 3 months after treatment. Results The scores of ATEC decreased after treatment (t>2.025, P<0.05), except that of Sociability;while the scores of PEP-3 increased (t>2.026, P<0.05), except that of Characteristic Motor Behaviors and Expressive Language. There were differences in improvement of Speech/Language/Communication and total score of ATEC, and Cognitive (Verbal/Preverbal), Receptive Language, Fine Motor, Gross Motor and Visual-Motor Imitation of PEP-3 between the experimental group and the control group after treatment (t>2.258, P<0.05). Conclusion Small muscle learning may promote the recovery of cognition, language and motor in children with ASD.