功能性电刺激康复踏车训练对痉挛型脑性瘫痪儿童下肢运动功能的效果

目的 探讨功能性电刺激(FES)康复踏车训练对痉挛型脑瘫儿童下肢运动功能的影响。方法 选取2017年11月至2020年12月北京博爱医院痉挛型偏瘫患儿36例,随机分为对照组(n = 18)和观察组(n = 18)。对照组每天进行2次常规康复训练,观察组在此基础上加1次FES康复踏车训练,共8周。治疗前后分别采用改良Ashworth量表(MAS)评价偏瘫侧腓肠肌、腘绳肌肌张力,10米步行测试评价步行速度的改变,6分钟步行测试评价步行耐力的改变,粗大运动功能测试(GMFM)的D区和E区评价步行功能,生理消耗指数(PCI)评价能量消耗。结果 观察组脱落2例。训练后,两组腓肠肌MAS评分无明显变化(t < 1.145, P > 0.05);观察组腘绳肌MAS评分显著降低(t = 4.869, P < 0.001),对照组无明显变化(t = 1.458, P > 0.05)。训练后,两组10 m步行速度、6 min步行距离、GMFM评分和PCI均显著改善(|t| > 6.241, P < 0.001),且观察组优于对照组(|t| > 2.097, P < 0.05)。结论 功能性电刺激康复踏车训练可改善痉挛型脑瘫儿童的下肢运动功能。

Effect of Functional Electrical Stimulation Rehabilitation Cycling on Lower Limb Motor Function in Children with Spastic Cerebral Palsy

Objective To explore the effect of functional electrical stimulation (FES) rehabilitation cycling on lower limb motor function in children with spastic cerebral palsy. Methods From November, 2017 to December, 2020, 36 children with spastic hemiplegia in Beijing Bo'ai Hospital were randomly divided into control group (n = 18) and observation group (n = 18). The control group received routine rehabilitation training twice a day, and the observation group received FES rehabilitation cycling in addition, for eight weeks. Before and after treatment, the muscle tension of gastrocnemius and hamstring muscles on hemiplegic side was evaluated by modified Ashworth Scale (MAS), the change of walking speed was evaluated by 10-meter walking speed, the change of walking endurance was evaluated by 6-minute Walking Test, the walking function was evaluated by areas D and E of Gross Motor Function Measure (GMFM), and the energy consumption was evaluated by physiological cost index (PCI).Results Two cases dropped out in the observation group. After training, there was no significant difference in MAS score of gastrocnemius muscle in both groups (t < 1.145, P > 0.05), the MAS score of hamstring muscle significantly decreased in the observation group (t = 4.869, P < 0.001), and no significant change was found in the control group (t = 1.458, P > 0.05). After training, the 10-meter walking speed, 6-minute walking distance, the score of GMFM and PCI significantly improved in both groups (|t| > 6.241, P < 0.001), and were better in the observation group than in the control group (|t| > 2.097, P < 0.05).Conclusion FES rehabilitation cycling training can improve the lower limb motor function of children with spastic hemiplegia.