| 石中嫣,施嘉英,熊文君,刘晓秀,谭权汉,计艳妹,张丽花,黄少昂.膈肌训练对脑瘫患儿膈肌功能及运动功能的影响[J].中国康复,2026,41(3):152-158 |
| 膈肌训练对脑瘫患儿膈肌功能及运动功能的影响 |
| Impact of diaphragm training on diaphragm function and motor function in children with cerebral palsy |
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| DOI：10.3870/zgkf.2026.03.005 |
| 中文关键词: 膈肌训练 核心稳定训练 脑瘫患儿 膈肌功能 运动功能 |
| 英文关键词: diaphragm training core stability training cerebral palsy diaphragm function motor function |
| 基金项目:广东省医学科学技术研究基金项目（A2024002） |
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| 中文摘要: |
| 目的：探讨膈肌训练、核心稳定训练与常规运动疗法对脑瘫患儿膈肌功能及运动功能的改善效果。方法：招募脑瘫患儿80例，分为常规组、核心组、膈肌组3组，3组均进行常规运动疗法康复训练，核心组在常规组基础上增加核心稳定训练，膈肌组在常规组基础上增加膈肌训练，比较3组患儿治疗前后膈肌功能指标：膈肌厚度(Tdi)吸气末和呼气末、膈肌增厚率(DTF)、膈肌移动度(DE)；运动功能指标：粗大运动功能量表（GMFM-88）D区E区评分；平衡与移动功能指标：儿童平衡功能量表（PBS）、“起立-行走”计时测试（TUGT）、10米步行试验（10MWT）。结果：治疗12周后，膈肌组和核心组的吸气 Tdi、呼气Tdi、DTF、DE较前明显提高（P＜0.05，0.01），膈肌组吸气 Tdi、DTF、DE高于核心组及常规组（P＜0.05），核心组DTF、DE高于常规组（P＜0.05）。运动功能指标： GMFM评测，3组D区、E区评分均较前提升（P＜0.05），核心组D区、E区评分高于常规组（P＜0.05），膈肌组E区评分高于常规组（P＜0.05）。膈肌组及核心组PBS评分较前提高（P＜0.05），且高于常规组（P＜0.05）；3组TUGT 用时均较前缩短（P＜0.05），膈肌组＜核心组＜常规组（P＜0.05）；10MWT评测（正常/最大速度），3组均较前提升（P＜0.05），膈肌组>核心组>常规组（P＜0.05）。结论：膈肌训练对脑瘫患儿膈肌功能、移动功能（步行速度及转移功能）改善更优，膈肌训练在平衡功能改善上与核心稳定训练相似，临床可根据患儿需求选择单一训练或联合干预。 |
| 英文摘要: |
| Objective：To explore the effects of diaphragm training, core stability training, and conventional exercise on improving diaphragm function and motor function in children with cerebral palsy. Methods: A total of 80 children with cerebral palsy were recruited and divided into three groups: conventional exercise group, core stability training group, and diaphragm training group. All three groups received conventional exercise; additionally, the core group received supplementary core stability training, and the diaphragm group received supplementary diaphragm training. Clinical outcomes were assessed using the following indicators: diaphragm function indicators: diaphragm thickness (Tdi), diaphragm thickening fraction (DTF), and diaphragmatic excursion (DE); motor function indicator: scores in zones D and E of the Gross Motor Function Measure (GMFM-88); balance and mobility indicators: Pediatric Balance Scale (PBS), Timed Up and Go Test (TUGT), and 10 Meter Walk Test (10MWT). Results: After 12 weeks of treatment: For diaphragm function, the inspiratory Tdi, expiratory Tdi, DTF, and DE in the diaphragm group and core group were significantly improved as compared with pre-treatment (P<0.05), the inspiratory Tdi, DTF, and DE in the diaphragm group were higher than those in the core group and conventional group (P<0.05), and the DTF and DE in the core group were higher than those in the conventional group (P<0.05). For motor function (GMFM), scores in zones D and E were significantly increased in all three groups as compared with pre-treatment (P<0.05). Scores in zones D and E of the core group were higher than those of the conventional group (P<0.05), and the score in zone E of the diaphragmatic group was higher than that of the conventional group (P<0.05). For balance and mobility: in terms of PBS scores, the diaphragm group and core group showed significant increases as compared with pre-treatment (P<0.05), and their scores were higher than those of the conventional group (P<0.05); regarding TUGT duration, all three groups showed significant reduction as compared with pre-treatment (P<0.05), with the duration in the order of diaphragm group < core group < conventional group (P<0.05); for 10MWT (comfortable/maximum speed), all three groups showed significant improvement as compared with pre-treatment (P<0.05), with the speed in the order of diaphragm group > core group > conventional group (P＜0.05). Conclusion: Diaphragmatic training has a better effect on improving diaphragm function and mobility (walking speed and transfer function) in children with cerebral palsy. Diaphragmatic training is similar to core stability training in improving balance function. In clinical practice, single training or combined intervention can be selected according to the children’s needs. |
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