运动康复和适应性身体活动对痉挛性脑性瘫痪儿童青少年心理运动功能、运动功能和动作发展的效益:基于ICF的循证研究OA北大核心CSTPCD

Objective To systematically review the evidences of impact of exercise rehabilitation and adapted physical activity on psychomotor skills,motor abilities,and motor development in children with spastic cerebral palsy(CP). Methods Relevant literature was retrieved from PubMed,Embase,Web of Science and CNKI,from January,2010 to June,2023.The contents were coded using International Classification of Diseases,Eleventh Revision,and Inter-national Classification of Functioning,Disability and Health;and evidences were analyzed with theoretical framework and code of ICD-11 and ICF. Results A total of nine articles were included,from Denmark,South Korea,Australia,Saudi Arabia,Ghana,India and Ja-pan,published from 2015 to 2022.The intervention programs primarily involved exercise rehabilitation(includ-ing physical therapy)and adapted physical activity.Exercise rehabilitation included upper limb strength training,lower limb strength training,balance and coordination training,gait training,functional aerobic exercise,stretch-ing and flexibility exercises,flexibility training,muscle relaxation techniques;ten to 50 minutes a time,two to six times a week,with the intensity of low to high,for six to 20 weeks.Adapted physical activities mainly in-volved adapted running training,virtual games;60 minutes a time,two to four times a week,with the intensity of medium to high,for six to twelve weeks.Interventions primarily took place in medical and rehabilitation institu-tions,schools,and home-based communities,with professionals including occupational physical therapists,uni-versity researchers,community health personnel and teachers.The outcomes were mainly reflected in four as-pects:psychomotor skills,motor abilities,motor development,and quality of life and well-being.In terms of psy-chomotor skills,adolescents with CP mastered running techniques and knowledge,and enhanced their response to balance threats.In terms of motor abilities,adolescents with CP showed an increase in muscle strength,en-hanced muscle endurance,and an expansion of muscle tone;improvements in gait functionality,walking ability,and gait symmetry;increases in walking endurance;improvements in standing function;and improvements in dy-namic balance;as well as enhanced control over balance posture.In terms of motor development,there was a sig-nificant improvement in activities of daily living,participation levels in school and leisure activities during free time,and an expanded range of motion.In terms of quality of life and well-being,adolescents with CP showed significant enhancements in self-confidence and self-esteem,significant relief from(spastic)pain,and improve-ments in social well-being and acceptance. Conclusion This systematic review has synthesized the evidences of benefits of exercise rehabilitation and adapted phys-ical activity on the psychomotor skills,motor abilities and motor development of children and adolescents with spastic CP.In terms of psychomotor skills,exercise rehabilitation and adapted physical activity help to improve the cognitive and motor skills of adolescents with spastic CP.In terms of motor abilities,exercise rehabilitation and adapted physical activity can improve muscle-related functions,gait and walking abilities,as well as balance and coordination.In terms of motor development,exercise rehabilitation and adapted physical activity significant-ly enhance activities of daily living and the level of participation in leisure physical activities.Finally,exercise re-habilitation and adapted physical activity can increase energy and motivation,alleviate pain,and enhance social well-being and acceptance.