经颅直流电刺激干预治疗对脑瘫患儿精细运动功能的影响

目的 分析经颅直流电刺激干预治疗对脑瘫患儿精细运动功能的影响,为临床应用提供理论依据。方法 选取2019年6月—2019年12月在郴州市第一人民医院康复科就诊的60例患者随机分为两组,观察组(30例)采用经颅直流电刺激联合常规康复治疗,对照组(30例)采用常规康复治疗。两组治疗均为1次/d,5次/周,共治疗6周。治疗前后观察两组的Peabody精细运动发育量表(PDMS-FM)与精细运动功能评估量表(FMFM)指数变化,分析疗效差异。结果 观察组和对照组总有效率差异无统计学意义(92.9%vs.82.5%,χ²=0.74,P＞0.05),两组愈显率差异有统计学意义(67.9%vs.37.3%,χ²=5.24,P<0.05);组间比较,治疗后观察组PDMS-FM量表中的抓握、视觉运动整合、粗细运动商(t/t′=4.71、2.54、2.67)与FMFM量表各项目评分(t/t′=4.35、2.74、3.31、2.52、2.15、2.58)均高于对照组,差异有统计学意义(P<0.05或<0.01);组内比较,两组治疗前后的PDMS-FM量表中的抓握、视觉运动整合、精细运动商(观察组t=16.67、23.13、6.59,对照组t=7.42、14.81、2.71)与FMFM量表各项目评分(观察组t/t′＝12.10、13.51、16.16、12.62、9.64、14.28,对照组t/t′＝8.46、12.11、9.26、19.95、12.97、15.79)均高于治疗前,差异均有统计学意义(P<0.01或<0.05)。结论 两种治疗方法对脑瘫患儿精细运动功能改善均有效,但结合经颅直流电刺激干预治疗的总体疗效要优于单一的常规康复治疗。

Effects of transcranial direct current stimulation intervention on fine motor function in children with cerebral palsy

Objective To analyze the effect of transcranial direct current stimulation (tDCS) intervention on fine motor function in children with cerebral palsy, in order to provide theoretical reference for clinical application. Methods A total of 60 children with cerebral palsy aged 4 to 6 years were selected in the rehabilitation department of Chenzhou First People′s Hospital from June to December 2019, and were randomly divided into 2 groups. The control group (n=30) was treated with conventional rehabilitation, while the observation group (n=30) was given tDCS additionally. Both groups were treated for 6 weeks, with a frequency of 1 time/day, 5 days/week. The Peabody Fine Motor Development Scale (PDMS-FM) and Fine Motor Function Evaluation Scale (FMFM) were used to evaluate the changes of the two groups. Then the effect of intervention was compared. Results There was no significant difference in total effective rate between observation group and control group (92.9%vs.82.5%,χ²=0.74, P>0.05). However, difference in recovery rate between the two groups was found significant (67.9%vs.37.3%,χ²=5.24, P<0.01). After treatment, PDMS-FM scores of grasping, visual motor integration, fine motor quotient (t/t′=4.71, 2.54, 2.67) and each item in FMFM scale index (t/t′=4.35, 2.74, 3.31, 2.52, 2.15, 2.58) in observation group was significantly higher than those in control group (P<0.01 or <0.05). In both observation group and control group, PDMS-FM scale index (observation group t=16.67,23.13,6.59 and control group t=7.42, 14.81, 2.71) and each item in FMFM scale index (observation group t/t′=12.10, 13.51, 16.16, 12.62, 9.64, 14.28 and control group t/t′=8.46, 12.11, 9.26, 19.95, 12.97, 15.79) after treatment scored higher than that before treatment (P<0.01 or <0.05). Conclusion Both treatments can effectively improve fine motor function of children with cerebral palsy, but rehabilitation combined tDCS intervention therapy has a better overall efficacy than conventional rehabilitation therapy alone.