全身振动训练对痉挛型脑瘫患儿20例步行速度及粗大运动功能影响研究

目的　探究全身振动训练对痉挛型脑瘫患儿步行及粗大运动能力的影响。方法　选取2019年1月至2019年12月在上海市第一人民医院康复医学科门诊行康复治疗的痉挛型脑瘫患儿40例，随机（抛硬币法）分为试验组（全身振动训练结合常规康复治疗）20例，对照组（常规康复训练）20例。分别于干预前、干预12周后评估粗大运动功能评定（GMFM-88）中D区（站立）、E区（走、跑、跳）评分；Peabody 运动发育量表（PDMS-2）中姿势项、移动项和实物操作项评分；10 m步行测试（10MWT），分析比较步行及粗大运动能力改善情况。结果　两组患儿干预前粗大运动功能分类系统（GMFCS）等级；GMFM-88中D区（站立）、E区（走、跑、跳）评分；PDMS-2中姿势项、移动项和实物操作项评分；10MWT差异均无统计学意义（P＞0.05）。治疗后，GMFM-88中的D区（站立）、E区（走、跑、跳）评分两组均有改善且试验组较对照组评分改善更为显著（P＜0.01）；PDMS-2中姿势项、移动项评分两组均有改善且试验组较对照组改善更为显著（P＜0.01），实物操作项评分比较两组组内、组间差异均无统计学意义（P＞0.05）；10MWT两组均有提高且试验组较对照组提高更明显（P＜0.01）。结论　全身振动训练结合常规康复治疗可促进痉挛型脑瘫患儿步行及运动功能改善。

Effect of whole body vibration on gait speed and gross motor function of pediatric patients with spastic cerebral palsy:A study of 20 cases

Objective To explore the effect of whole body vibration on gait speed and gross motor function of pediatric patients with spastic cerebral palsy.Methods Forty pediatric patients with spastic cerebral palsy were recruited from the Out-patient Department of Rehabilitation,Shanghai General Hospital between January 2019 and December 2019,who were randomly distributed to experimental group under whole body vibration combined with conventional rehabilitation,and control group with conventional rehabilitation alone,20 patients in each group.The assessments were done before and after 12-week intervention via score on Dimension D(standing)and Dimension E(walking,running,jumping)in GMFM-88,the score on stationary,locomotion,object manipulation in PDMS-2,and 10-Meter Walking Test,in order to analyze the improvement in the condition of gait and gross motor function.Results The level of GMFCS,score on Dimension D(standing)and Dimension E(walking,running,jumping)in GMFM-88,stationary,locomotion and object manipulation in PDMS-2,and 10-Meter Walking Test were of no significant difference before intervention between the two groups(P>0.05).After treatment,scores on Dimension D(standing)and Dimension E(walking,running,jumping)in GMFM-88 were improved in both groups and the experiment group had greater improvement with significant difference compared with control group(P<0.01);the same was with the score on stationary and locomotion in PDMS-2(P<0.01)and 10MWT(P<0.01).The score on object manipulation in PDMS-2 were of no statistical difference in each of or between the two groups(P>0.05).Conclusion Whole body vibration combined with conventional rehabilitation can promote the gait and motor function improvement in pediatric patients with spastic cerebral palsy.