踝关节 CPM 对脑瘫足外翻的疗效分析

目的观察持续被动运动(CPM)在改善脑瘫患儿足外翻方面的效果及临床意义。方法本研究共57例儿童,分为正常组及外翻组,将外翻组患儿随机分为对照组、非CPM 组及 CPM 组。对照组未行任何康复治疗,非 CPM 组给予常规康复治疗,CPM 组给予常规康复治疗及 CPM 治疗。对正常组儿童行足底压力测量技术进行评估并记录,且分别于治疗前、治疗后第2个月及第4个月对外翻组行足底压力测量技术评估。结果与正常组相比,外翻组足弓内侧缘(MMF)、足跟(HEEL)压力百分比、着地时相及前足掌接触时相(ICP + FFCP)百分比明显增高,足前掌外侧缘(LFF)、足弓外侧缘(LMF)压力百分比及整足接触时相(FFP)百分比明显降低( P <0．05)。非 CPM 组、CPM 组在治疗前后MMF 压力百分比、FFP 百分比均减少(P <0．05),ICP + FF-CP 百分比增大(P <0．05)；较非 CPM 组、对照组,CPM 组的MMF 压力百分比改善更明显(P <0．01),ICP + FFCP 百分比改善更明显(P <0．05)。结论踝关节持续被动运动能缓解小龄脑瘫足外翻患儿外翻肌的痉挛和挛缩,促进小龄患儿的足弓形成,使动态步行时各肌群协调性增强,从而改善脑瘫患儿步行能力。

The treatment of continuous passive motion on talipes valgus in the children with cerebral palsy

Objective To observe the treatment of continuous passive motion(CPM) on talipes valgus in the chil-dren with cerebral palsy. Methods There were 57 children in this research including normal group and valgus group, the children in valgus group were randomly divided into control group, non-CPM group and CPM group. The control group didn’t receive any rehabilitation treatment. The non-CPM group received conventional rehabilita-tion treatment. The CPM group received conventional rehabilitation and CPM therapy. Evaluate the children in nor-mal group with plantar pressure analysis and evaluate each patient before treatment two and four months after treat-ment with plantar pressure analysis. Results Compared with the normal group, the percentage of medial midfoot (MMF) pressure, HEEL pressure, initial contact phase(ICP) and forefoot contact phase(FFCP) were obviously higher in valgus groups. On the other hand, the percentage of lateral forefoot ( LFF) pressure, lateral midfoot (LMF) pressure and foot flat phase(FFP) were obviously lower in valgus groups(P < 0. 05). The percentage of MMF pressure, and FFP became lower after treatment in both CPM group and non-CPM group while the percentage of ICP and FFCP became higher(P < 0. 05). In CPM group there was a more obvious change with the percentage of MMF pressure, ICP and FFCP compared with non-CPM group and the control group(P < 0. 05). Conclusion U-sing CPM can alleviate muscle spasms and contracture, correct the deformity of midfoot, enhance the muscle group coordination on foot and further more improve gait of patients with cerebral palsy.