GMAE软件系统在脑瘫患儿评估及康复治疗中的临床意义

目的为脑瘫患儿粗大运动功能障碍程度及康复疗效评估提供科学、简便的工具。方法采用GMAE、GDSGM分别对34例脑瘫患儿治疗前后粗大运动功能进行评估比较。对83例脑瘫患儿随机分组,分别在治疗前后评估,将得分输入GMAE进行数据分析。A组：治疗时间3个月,常规治疗加GMAE提供的预期训练目标;B组：治疗2个月,方案同A组;C组：仅常规治疗3个月。对照组为30例健康患儿,两次测评间隔3个月。结果 34例脑瘫患儿治疗前后评估,GMAE结果差异显著（t=5.26,P〈0.0001）;GDS-GM结果差异不显著（S=87.5,P〉0.05）。83例患儿中,各组首次、二次检测及两次检测GMAE结果差值均低于对照组（P〈0.05）;A组两次检测结果差值明显高于B组和C组（P〈0.05）。对照组中,3岁以上组GMAE首次测量值显著高于3岁以内组（P〈0.05）。3岁以内组两次测量差值明显高于3岁以上儿童,差异显著（P〈0.05）。结论 GMAE可量化脑瘫患儿粗大运动功能障碍程度及康复训练后进步变化幅度,具有科学、简便、实用的特点。其敏感性、特异性均优于GDS-GM。还能反映不同年龄粗大运动发育水平的特点,其显示的预期训练目标对脑瘫患儿个体精细化康复训练有一定的指导意义,适合国内临床广泛使用。

Clinical significance of GMAE software system in the evaluation and rehabilitation of children with cerebral palsy

Objective： To Provide a convenient tool for evaluation of gross motor dysfunction and the effects of rehabilitation in children with cerebral palsy. Methods： GMAE and GDS-GM were selected to compare and evaluate the gross motor function before and after rehabilitation in 34 children with cerebral palsy. 83 children with cerebral palsy were randomly divided into 3 groups, the scores of each child before and after treatment was put into GMAE for statistical analysis. Group A- normal rehabilitation and expected goals of GMAE for 3 months. Group B： the same treatment as group A but for only two months. Group C= normal rehabilitation for 3 months. Control group： 30 healthy children and the evaluation interval was 3 months.Restuls- GMAE scores showed significant difference after the therapy （t=5.26, P〈0.0001） , while GDS-GM scores did not show such difference （S=87.5, P〉0.05） . In 83 subjects, scores of first and second measurement, as well as the differences between these two measurements were significantly lower than those of the control group （P〈0.05） . Interestingly, the differences between the two measurements in group A were significantly higher than those in group B and C （P〈0.05） . In the contrl group, the GMFM scores of first measurement of subjects more than 3 years old was significantly fiigher than those of subjects less than 3 years old （P〈0.05） . Score differences of the two measurements of subjects less than 3 years old were signiiScantly higher than those of subjects high than 3 years old （P〈0.05） . Conclusion： GMAE could quantify the level of gross motor dysfuntion and the extent of improment after rehabilitation in children with cerebral palsy. It is better than GDS-GM in terms of sensitivity and specificity. GMAE could also reflect the level of gross motor fuction in different age groups. The expected goals of rehabilitation of GMAE shed lights to the personalized rehabilitation in children with cerebral palsy. Therfore, it should be widely used in clini