新医学2025，Vol.56Issue(11)：1100-1108,9.DOI:10.12464/j.issn.0253-9802.2025-0152
两种不同模式"脑-肢协同"治疗对痉挛型偏瘫脑瘫患儿上肢运动功能的影响
Effects of two different modes of"brain-limb cooperative therapy"on the motor function of upper limbs in children with spastic hemiplegic cerebral palsy
摘要
Abstract
Objective To observe the improvement of upper limb motor function in children with hemiplegic spastic cerebral palsy(HSCP)by different time serial modes of"brain-limb coordination".Methods Clinical data of 60 children with HSCP admitted to Department of Children's Rehabilitation,Xuzhou Children's Hospital Affiliated to Xuzhou Medical University from June 2023 to August 2024 were retrospectively analyzed.All patients were randomly divided into the observation group(n=30)and control group(n=30).Patients in two groups were treated with routine rehabilitation,combined with repeated transcranial magnetic stimulation and massage,respectively.In addition,synchronous mode of"brain-limb coordination"was adopted in the observation group,while asynchronous mode of"brain-limb coordination"in the control group for consecutive 12 weeks.The muscle tension of biceps brachii and flexor carpi in hemiplegic upper limbs was evaluated by Modified Ashworth Scale(MAS).The grasping ability and visual-motor comprehensive ability were assessed by Peabody Developmental Motor Scale-Fine Motor(PDMS-FM)and Fine Motor Quotient(FMQ),respectively.The upper limb function was evaluated by Carroll Upper Extremity Function Test(UEFT).The changes of upper limb muscle tension grade were observed before and after treatment.The upper limb motor function,hand fine motor quotient,upper limb grasping function and hand coordination score were statistically compared between two groups.Independent sample t test was used for comparison between two groups,and paired t test was used for intra-group comparison before and after interventions.Results After 12 weeks of treatment,children in the two groups obtained lower MAS scores of biceps brachii(t=-7.259,-3.924;both P＜0.05)and flexor carpi(t=-10.818,-6.233;both P＜0.05)compared with those before treatment.The muscle tension MAS scores of biceps brachii and flexor carpi in the observation group were lower than those in the control group(t=-2.195,-2.322;both P＜0.05).The PDMS-FM scores(t=14.035,12.269;both P＜0.05)and FMQ scores(t=11.987,7.773;both P＜0.05)in two groups were higher than those before treatment.In addition,the PDMS-FM and FMQ scores in the observation group were higher than those in the control group(t=2.784,3.448;both P＜0.05).The UEFT scores of grasping(t=5.277,2.755;both P＜0.05),UEFT score of coordination(t=5.115,8.428;both P＜0.05)and the total UEFT score(t=5.960,3.467;both P＜0.05)in two groups were higher than those before treatment.Moreover,the UEFT score of grasping and total UEFT score in the observation group were higher than those in the control group(t=2.437,2.269;both P＜0.05),whereas no significant difference was noted in the UEFT score of bilateral hand coordination between two groups(t=0.679;P>0.05).Conclusion Synchronous mode of"brain-limb coordination"can effectively improve muscle tension and motor function of the upper limbs in children with HSCP,which yields better rehabilitation efficacy compared with asynchronous mode.关键词
脑性瘫痪/痉挛型偏瘫脑瘫/重复经颅磁刺激/脑-肢协同/上肢运动功能Key words
Cerebral palsy/Hemiplegic spastic cerebral palsy/Repeated transcranial magnetic stimulation/Brain-limb coordination/Upper limb motor function引用本文复制引用
李新剑,王莉,吴野,鲍克秀..两种不同模式"脑-肢协同"治疗对痉挛型偏瘫脑瘫患儿上肢运动功能的影响[J].新医学,2025,56(11):1100-1108,9.基金项目
江苏省卫生健康委项目(Z2023002) （Z2023002）
徐州市卫生健康委项目(XWKYHT20210539) （XWKYHT20210539）
