不同强化训练对脑性瘫痪儿童上肢运动功能效果的网状Meta分析OA北大核心CSTPCD
Effect of different intensive training on upper limb motor function in children with cerebral palsy:a network me-ta-analysis
目的 系统评价上肢强化训练对脑瘫儿童上肢运动功能的效果. 方法 构建PICO架构,检索PubMed、Embase、Cochrane Library、Scopus、Web of Science、中国知网、中国生物医学文献数据库、维普和万方数据库,搜集关于上肢强化训练改善脑瘫儿童上肢运动功能的随机对照试验,检索时限均为2010年1月至2024年3月.按照Cochrane系统评价手册和物理治疗证据数据库量表对纳入文献进行质量评价,由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.4和Stata 17.0进行网状Meta分析. 结果 共纳入27篇文献,包括1 173例患者,涉及3种上肢强化训练.强制性运动疗法、改良强制性运动疗法和手-臂双侧强化训练均可提高辅助手功能评分与Peabody精细运动功能评分;强制性运动疗法和改良强制性运动疗法可提高上肢技能质量量表评分;手-臂双侧强化训练可提高儿童生活功能量表评分.在提高辅助手功能、上肢技能质量量表评分和Peabody精细运动功能评分方面,强制性运动疗法为最佳干预方式;在提高儿童生活功能量表评分方面,手-臂双侧强化训练为最佳干预方式. 结论 上肢强化训练可显著改善脑瘫儿童的上肢运动功能、精细运动功能和日常生活活动能力,强制性运动疗法在改善上肢运动功能和精细运动功能方面效果最好,手-臂双侧强化训练在提高日常生活活动能力方面疗效最佳.
Objective To systematically review the effect of upper extremity intensive training on upper limb motor function in chil-dren with cerebral palsy. Methods The PICO framework was constructed.PubMed,Embase,Cochrane Library,Scopus,Web of Science,CNKI,CBM,VIP and Wanfang data were retrieved for randomized controlled trials on the improvement of upper limb motor function in children with cerebral palsy by upper extremity intensive training from January,2010 to March,2024.The quality of the included researches was evaluated using the Cochrane System Evaluation Manu-al and Physiotherapy Evidence Database scale.Two reviewers independently screened literature,extracted data and assessed the risk of bias.Network meta-analysis was conducted using RevMan 5.4 and Stata 17.0. Results A total of 27 randomized controlled trials were selected,including 1 173 cases,involving three kinds of upper extremity intensive training.Constraint-induced movement therapy,modified constraint-induced movement thera-py and hand-arm bimanual intensive therapy improved Assistive Hand Assessment score and Peabody Develop-mental Motor Scale-Fine Motor score;constraint-induced movement therapy and modified constraint-induced movement therapy improved the Quality of Upper Extremity Skills Test score;hand-arm bimanual intensive ther-apy improved Pediatric Evaluation of Disability Inventory score.Constraint-induced movement therapy was the best in improving the Assistive Hand Assessment score,Quality of Upper Extremity Skills Test score and Pea-body Developmental Motor Scale-Fine Motor score,while hand-arm bimanual intensive therapy was the best in improving the Pediatric Evaluation of Disability Inventory score. Conclusion Upper extremity intensive training can significantly improve upper limb motor function,fine motor function and activities of daily living in children with cerebral palsy.Constraint-induced movement therapy is the best in improving upper limb function and fine motor function,and hand-arm bimanual intensive therapy is the best in improving the activities of daily living.
崔甜甜;杨钰琳;崔腾腾;马丽虹
山东中医药大学康复医学院,山东济南市 250355山东第二医科大学康复医学院,山东潍坊市 261100
临床医学
脑性瘫痪上肢强化训练强制性运动疗法运动功能网状Meta分析
cerebral palsyupper extremityintensive trainingconstraint-induced movement therapymotor functionnetwork meta-analysis
《中国康复理论与实践》 2024 (004)
437-448 / 12
山东省高等医学教育研究中心科研规划项目 Supported by Research Planning Project of Shandong Higher Medical Education Research Center
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