步态诱发功能性电刺激对痉挛型脑瘫足下垂患儿的疗效

目的:观察应用功能性电刺激(FES)治疗痉挛型脑瘫偏瘫患儿足下垂的疗效.方法:痉挛型脑瘫偏瘫患儿24例分为观察组和对照组各12例,2组均进行运动训练、物理因子等治疗.观察组在此基础上应用FES对偏瘫侧腓总神经进行神经肌肉电刺激治疗(NMES),同时进行步行训练.治疗前后分别用改良的Ashworth量表测定患儿腓肠肌肌张力的变化、关节量角器法测量下肢踝关节主动背屈角度和粗大运动功能量表(GMFM-88)之D区(站立)、E区(走跑跳)分值.结果:治疗12周后,2组患儿患侧腓肠肌肌张力评分均较治疗前显著降低(P＜0.01),且观察组更低于对照组(P＜0.05)；2组GMFM-88之D、E区评分及踝关节主动背屈角度均高于治疗前(P＜0.01),且观察组更高于对照组(P＜0.05).结论:FES配合康复功能训练能改善痉挛型脑瘫偏瘫患儿的踝关节活动范围,提高下肢运动功能.

Effectiveness of gait triggered functional electrical stimulation on foot drop of spastic cerebral palsy children

Objective:To observe the effectiveness of functional electrical stimulation (FES) for children with spastic hemiplegic cerebral palsy (CP)-induced foot drop.Methods:Twenty-four children with spastic hemiplegic CP were divided into control group and observation group (n=12 each group).All children were subjected to motor training and physical agents therapy.The observation group was given neuromuscular electrical stimulation (NMES) on common peroneal nerve of affected side by using XFT-2001 FES and 30-min walking training was done once a day.The modified Ashworth scale of the hemiplegic lower limb,the ankle angle of active dorsiflexion motion and D and E domains of Gross Motor Function Measure (GMFM-88) were performed to comparatively evaluate the effectiveness before and after treatment.Results:The muscle tone score of the hemiplegic lower limb was significantly decreased 12 weeks after treatment in both two groups as compared with pre treatment (P<0.01),and that in observation group were reduced more significantly than in control group (P<0.05).D and E domains of GMFM-88 scores and the ankle angle of active dorsiflexion motion were increased after treatment in both two group as compared with pre-treatment (P<0.01),and those in the observation group were higher than in the control group (P<0.05).Conclusion:FES in combination with rehabilitation functional training in the treatment for children with spastic hemiplegic CP can effectively increase the range of ankle motion, and improve gross motor function of lower extremities.