目的 探究全身振动训练对痉挛型脑瘫患儿步行及粗大运动能力的影响.方法 选取2019年1月至2019年12月在上海市第一人民医院康复医学科门诊行康复治疗的痉挛型脑瘫患儿40例,随机(抛硬币法)分为试验组(全身振动训练结合常规康复治疗)20例,对照组(常规康复训练)20例.分别于干预前、干预12周后评估粗大运动功能评定(GMFM-88)中D区(站立)、E区(走、跑、跳)评分;Peabody运动发育量表(PDMS-2)中姿势项、移动项和实物操作项评分;10m步行测试(1OMWT),分析比较步行及粗大运动能力改善情况.结果 两组患儿干预前粗大运动功能分类系统(GMFCS)等级;GMFM-88中D区(站立)、E区(走、跑、跳)评分;PDMS-2中姿势项、移动项和实物操作项评分;1OMWT差异均无统计学意义(P＞0.05).治疗后,GMFM-88中的D区(站立)、E区(走、跑、跳)评分两组均有改善且试验组较对照组评分改善更为显著(P＜0.01);PDMS-2中姿势项、移动项评分两组均有改善且试验组较对照组改善更为显著(P＜0.01),实物操作项评分比较两组组内、组间差异均无统计学意义(P＞0.05);10MWT两组均有提高且试验组较对照组提高更明显(P＜0.01).结论 全身振动训练结合常规康复治疗可促进痉挛型脑瘫患儿步行及运动功能改善.

Objective To explore the effects of intensive therapy program on gross motor function of children with spastic cerebral palsy.Methods Thirty 3-15 year old children with spastic cerebral palsy and level Ⅰ-Ⅲ in gross motor function classification system (GMFCS) were randomly divide into 2 groups.The trial group adopted intensive therapy program for treatment,including functional dynamic suit and universal exercise unit combined with functional movement training.The control group adopted core stability training for treatment.Children in two groups took a 1-month training program for 3 hours per day and 5 days per week.The pediatric evaluation of gross motor function measure (GMFM-66) and peabody developmental motor scale (PDMS-2) were administered before and after treatment.Results The scores of GMFM-66 as well as the stationary and locomotion scores of PDMS-2 in both groups showed significant differences within group (P ＜ 0.01) after treatment.For the scores of GMFM and PDMS-2 between two groups,no significant differences were found.Conclusions The intensive therapy program can improve the gross motor function of children with spastic cerebral palsy and gain the same effects as core stability training,which can provide a novel and effective intervention for children with cerebral palsy.

Objective: hTe result of quantitative assessment of the whole spinal lfexion, extension, letf and right side lfexion mobility for adolescent idiopathic scoliosis (AIS) patients with SpinalMouse was used to do the correlation analysis with the Cobb angle of the main curve, apical vertebral rotation and brace use time respectively to determine how to design the medical exercises training.Methods: hTis study included 48 patients with AIS (8 males, 40 females), selected from January 2014 to May 2016 in our center. With mean age (13.46±2.00) years old, mean Cobb angle 24.29°±9.48°, mean Risser sign 2.21°±1.80°, mean main apical rotation 1.08°±0.77°, mean brace use time (17.54±21.36) months. Measured the whole spinal lfexion, extension, letf and right side lfexion mobility in four directions for AIS patients with SpinalMouse.Results: It showed negative correlation between Cobb angle, apical vertebral rotation, brace use time and the whole spinal side lfexion mobility (P<0.01), but there was no signiifcant correlation between Cobb angle, apical vertebral rotation, brace use time and the whole spinal side lfexion mobility (P>0.05).Conclusion: hTe severity of Cobb angle, apical vertebral rotation, and long-time use brace inlfuence the whole spinal side lfexion mobility. However, it doesn’t inlfuence the whole spinal lfexion and extension mobility.

Objective To evaluate the effects of conductive education on comprehensive capacity for children with spastic cerebral palsy.Methods Select 75 children with spastic cerebral palsy from all children who saw the doctor from January 2011 to December 2012 in Yangzhi hospital Shanghai Sunshine Rehabilitation Center,and randomly divide them into three groups,study group (n =25),control group one (n =25) and control group two (n =25).The study group was on the basis of conventional rehabilitation increasing conductive education,control group one was given conventional treatment and control group two was given a one-time family rehabilitation guidance.We did the assessment both before and after six-month treatment by Gross Motor Function Scale (GMFM-66),fine Motor Function Scale (FMFM) and Functional Independence Scale (WeeFIM) for Children.Results Gross motor function improved after treatment in three groups.There were statistical differences (study group,t =19.271,P ＜0.01 ; control group one,t =15.464,P ＜0.01 ; control group two,t =2.416,P ＜0.05).Fine motor function and daily life independent capacity of study group and control group one significantly improved and the differences were statistically significant (P ＜ 0.01).For control group two after treatment,fine motor function and activities of daily living showed no statistical differences (P ＞ 0.05).After treatment,gross mnotor function,fine motor function and daily life independent capacity of study group were all better than two control groups.And the differences were statistically significant (P ＜ 0.01).Conclusion The combination of conventional rehabilitation and conductive education may be more effective in improving overall efficacy for children with spastic cerebral palsy.