文章摘要
杨雪,刘青,曹建国,贠国俊,王玉娟,王景刚,陈土容.体外冲击波联合肉毒毒素治疗对痉挛型脑瘫运动功能和身体活动的影响[J].中国康复,2019,34(7):339-342
体外冲击波联合肉毒毒素治疗对痉挛型脑瘫运动功能和身体活动的影响
Effects of extracorporeal shock wave therapy combined with botulinum toxin type A on motor function and physical activity in children with spastic cerebral palsy
  
DOI:
中文关键词: 脑性瘫痪  痉挛  身体活动  体外冲击波  肉毒毒素
英文关键词: cerebral palsy  spasticity  physical activity  extracorporeal shock wave  botulinum toxin
基金项目:广东省医学科学技术研究基金项目(A2016415)
作者单位
杨雪 深圳市儿童医院康复科广东 深圳 518038 
刘青 深圳市儿童医院康复科广东 深圳 518038 
曹建国 深圳市儿童医院康复科广东 深圳 518038 
贠国俊 深圳市儿童医院康复科广东 深圳 518038 
王玉娟 深圳市儿童医院康复科广东 深圳 518038 
王景刚 深圳市儿童医院康复科广东 深圳 518038 
陈土容 深圳市儿童医院康复科广东 深圳 518038 
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中文摘要:
      目的:探讨体外冲击波(ESW)联合肉毒毒素(BoNT A)治疗对痉挛型脑瘫下肢运动功能和身体活动的影响。方法:将60例2~10岁痉挛型脑瘫儿童随机分为对照组和治疗组各30例,2组均接受患侧小腿三头肌BoNT A注射及常规康复治疗,治疗组在BoNT A注射24h后给予低能量ESW治疗。治疗前后对2组患儿的改良Asworth分级(MAS)、粗大运动功能评分(GMFM)D区和E区、身体活动水平进行评估。结果:治疗后,2组患儿MAS评分降低、GMFM D区和E区评分均较治疗前明显增加(P<0.05),治疗组MAS降低和D区评分增加较对照组显著(P<0.05)。治疗后,2组患儿的静坐时间百分比减少、轻强度身体活动时间百分比增加(P<0.05),且治疗组改善幅度较对照组显著(P<0.05)。结论:ESW联合BoNT A治疗是改善痉挛型脑瘫肌痉挛、站立功能及身体活动的有效方法,比单独BoNT A治疗效果更佳。
英文摘要:
      Objective: To investigate the effect of extracorporeal shock wave (ESW) therapy combined with botulinum neurotoxin A (BoNT A ) on motor function and physical activity in children with spastic cerebral palsy. Methods: Sixty children with spastic cerebral palsy (2 10 years old) were randomized into control group and treatment group. Participants in both groups received BoNT A injection into triceps surae muscle of the affected limbs and regular rehabilitation therapy simultaneously. Additionally, the treatment group received ESW therapy 24 h after BoNT A injection. Modified Ashworth Scale (MAS), Gross Motor Function Measure (GMFM) and physical activity were assessed before and 3 months after treatment. Results: The scores of MAS decreased, and scores of GMFM at D and E regions increased in both groups after treatment (all P<0.05). These changes of MAS and GMFM D scores were more significant in treatment group than in control group (P<0.05). Both groups spent less percentage of time in sedentary behavior and more percentage of time in light activity after treatment (all P<0.05), and these changes were more significant in the treatment group than in the control group (P<0.05). Conclusion: Compared to BoNT A injection alone, its combination with ESW therapy can release muscle spasm, improve gross motor function and physical activity level more effectively in children with spastic cerebral palsy.
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