脑瘫儿童和青少年粗大运动功能、手功能、沟通功能分级相关性分析

目的分析不同类型和年龄的脑瘫儿童和青少年的粗大运动功能、手功能及沟通功能受损情况及三大功能之间的相互关系,为临床制定康复干预目标和计划提供更多依据。方法2018年1月-2019年3月应用中文版脑瘫粗大运动功能分级系统-扩展和修订版(GMFCS-ER)、中文版Mini手功能分级系统(Mini-MACS)及中文版MACS、中文版沟通功能分级系统(CFCS)对119例2~18岁脑瘫儿童和青少年进行粗大运动功能、手功能、沟通能力进行评定分级。结果63.9%的儿童和青少年GMFCS分级和54.7%儿童和青少年CFCS分级处于Ⅰ级和Ⅱ级,52.9%的MACS分级为Ⅱ级和Ⅲ级,偏瘫患儿的三种功能大多集中在Ⅰ~Ⅲ级;119名对象中有22名(18.5%)三种功能分级水平相同;三种功能分级间具有中等程度相关性(r=0.62~0.70,P<0.001)。结论三个分级系统是相互补充且相互影响,仅使用一个功能分级系统并不能十分贴切地描述脑瘫儿童和青少年的整体活动功能状态。

Correlation analysis of gross motor function,hand function and communication function in children and adolescents with cerebral palsy

Objective To analyze the relationship between gross motor function, operation function and communication function impairment and three major functions of children and adolescents with different types and age,in oroler to proviole reference for making rehabilitation strategies. Methods The Chinese version of the cerebral palsy Gross Motor Function Classification System extended and revised version (GMFCS-ER), the Chinese version of mini-MACS and the Chinese version of Manual Ability Classification System (MACS), the Chinese version of Communication Function Classification System (CFCS) were used to perform gross motor function on 119 children and adolescents with cerebral palsy aged 2 to 18 years old.Hand function and communication ability were evaluated and graded. Results 63.9% of children and adolescents had a GMFCS grade and 54.7% had grade Ⅰ and Ⅱ CFCS,52.9% of grades were graded Ⅱ and Ⅲ, and most of the three functions of children with hemiplegia grade Ⅰ-Ⅲ.22 of the 119 subjects (18.5%) had the same levels of three functional grades.Three functional grades had a moderate correlation in assessing children with cerebral palsy (r=0.62-0.70, P<0.001). Conclusions The three grading systems complement each other and influence each other.The use of only one functional grading system does not describe the overall functional status of children and adolescents with cerebral palsy.