矫形鞋垫联合踝关节持续被动运动用于偏瘫型脑瘫患儿步态稳定性控制的临床研究

目的:探讨矫形鞋垫联合踝关节持续被动运动(CPM)用于偏瘫型脑瘫患儿姿势控制的临床价值。方法:选择2016年6月~2017年6月在我院康复科就诊的56例偏瘫型脑瘫患儿,随机均分成两组。对照组患儿每日行物理治疗(PT)训练,每次共30分钟,每日一次,每周五次。治疗组患儿常规物理治疗训练同对照组,并同时运用足部生物力学矫形技术及踝关节CPM治疗,每次15分钟,角度恒定为-45-45度,每天一次。两组治疗疗程为三个月。治疗结束后,比较两组患儿的儿平衡能力总有效率、GMFM(E功能区评分)、肢体运动功能、踝关节张力及踝关节活动范围的改善情况。结果:两组患儿平衡能力总有效率(显效率与有效率之和)分别为92.9%和67.9%,治疗组明显优于对照组(P0.05)。治疗组治疗后GMFM(E功能区评分比较)明显高于对照组(P0.01),患侧肢体运动功能改善、踝关节张力、踝关节活动范围改善情况均明显优于对照组(P0.05)。结论:矫形鞋垫联合踝关节CPM明显有助于偏瘫型脑瘫患儿姿势控制的治疗。

A Clinical Study on the Gait Stability Control of Orthopedic Insole Combined with Ankle Joint CPM in Children with Hemiplegic Cerebral Palsy

ABSTRACT Objective: To explore the clinical value of orthopedic insole combined with continuous passive movement of ankle joint (CPM) for postural control of children with hemiplegic cerebral palsy. Methods: Choose 48 cases of hemiplegic cerebral palsy rehabilitation clinic of our hospital from June 2016 to June 2017, randomly divided into two groups, The children in the control group were trained with physical therapy (PT) every day, 30 minutes a day, once a day, five times a week. The children in the treatment group were treated with conventional physical therapy training as compared with the control group. At the same time, the foot biomechanics correction technique and CPM treatment of ankle joint were used at the same time, 15 minutes each time, the angle constant was -45 - 45 degrees, once a day. The two groups were treated for three months. After treatment, the total effective rate of children''s balance ability, GMFM (E functional area score), limb motor function, ankle tension and ankle range of motion were compared between the two groups. Results: The total effective rate of balance in the two groups was 92.9% and 67.9 % respectively, and the treatment group was significantly better than the control group (P<0.05). After treatment, the GMFM (E functional area score) in the treatment group was significantly higher than that in the control group (P<0.01), and the improvement of motor function, ankle tension and ankle range of motion in the affected side were significantly better than those in the control group (P<0.05). Conclusion: Orthopedic insole combined with ankle CPM can be helpful for the treatment of postural control in children with hemiplegic cerebral palsy.