应用磁共振扩散张量成像技术评价手-臂双侧强化训练对痉挛型偏瘫患儿上肢功能的临床效果

目的:研究手-臂双侧强化训练(HABIT)治疗痉挛型偏瘫患儿后大脑功能代偿情况以及上肢功能的改善情况。方法:将痉挛型偏瘫患儿随机分为研究组和对照组，每组各10例，2组均给予常规作业康复治疗，研究组在常规作业康复治疗的基础上采用HABIT治疗。在治疗前后对所有偏瘫患儿采用磁共振扩散张量成像技术评估各向异性系数(FA),进行上肢功能试验(UEFT)、Peabody运动发育量表-2(PDMS-2)量表评估。结果:治疗21d后，2组患儿的FA值、UEFT评分、PDMS-2抓握及视觉运动评分均较治疗前明显提高(均P<0.05),治疗后研究组上述评分均较对照组明显提高(均P<0.05)。结论:手-臂双侧强化训练可以明显改善痉挛型偏瘫患儿的上肢功能。

Clinical study on the evaluation of upper limb function in children with spastic hemiplegia after hand-arm bimanual intensive training by diffusion tensor imaging

Objective: To study the compensation of brain function assessed by fMRI after bimanual hand-arm bimanual intensive training (HABIT) treatment and the improvement of upper limb function in children with spastic hemiplegia after HABIT treatment. Methods: Children with spastic hemiplegia were selected as the research objects and randomly divided into the study group and the control group, with 10 cases in each group. Both groups were given routine occupational rehabilitation therapy, and the research group received HABIT therapy on the basis of routine occupational rehabilitation therapy. Before and after treatment, all the children were evaluated by fMRI, upper extremity function test and PDMS-2. Results: There was no significant difference in sex, age, MACS grade and other general data between the two groups before treatment. Compared with those before treatment, FA value, UEFT score, PDMS-2 grip score and PDMS-2 visual motor score were increased in both groups (P<0.05). After treatment, the FA value of each area, UEFT score, PDMS-2 grasping score, PDMS-2 visual motor score in the study group were significantly higher than those in the control group (P<0.05). Conclusion: Intensive hand training can significantly improve the upper limb function of children with spastic hemiplegia.