重复经颅磁联合体外冲击波对偏瘫患儿下肢功能的临床研究

目的 研究重复经颅磁结合体外冲击波治疗对偏瘫患儿下肢功能的影响,为重复经颅磁结合体外冲击波在偏瘫患儿康复中的应用提供科学依据。方法 选取2019年5月—2021年5月深圳市儿童医院康复医学科住院收治的偏瘫患儿60例,通过随机数字表法分为研究组和对照组,两组患儿均接受常规康复训练及体外冲击波治疗,研究组在此基础上增加重复经颅磁干预。两组患儿在治疗前和治疗后分别进行患侧下肢肌张力评估,足底压力、足底面积以及GMFM-88评估。结果 治疗后研究组和对照组组内的肌张力均较治疗前有降低(t=4.521、3.789),足底压力(t=8.412、7.354)、足底面积明显增大(t=4.585、10.251),GMFM-88项D区(t=11.247、9.254)和E区得分均有提高(t=8.738、6.254),差异均有统计学意义(P<0.05);治疗后研究组较对照组肌张力明显降低,足底压力、足底面积、GMFM-88项D区和E区的得分均显著提高,差异有统计学意义(t=7.213、5.134、4.233、8.646、7.463,P<0.05)。结论 重复经颅磁刺激联合体外冲击波治疗可以有效改善偏瘫患儿的下肢运动功能及步态表现。

Clinical effect of repetitive transcranial magnetic stimulation combined with extracorporeal shock ware treatment on lower limb function in children with hemiplegia

Objective To observe the clinical effect of repetitive transcranial magnetic stimulation (rTMS) combined with extracorporeal shock wave (ESW) treatment on the lower limb function of children with hemiplegia, so as to provide scientific reference for the rehabilitation of these children. Methods A total of 60 children with hemiplegic cerebral palsy were randomly assigned to the study group and control group.Both groups received conventional rehabilitation therapy and extracorporeal shock wave therapy, while participants in the intervention group underwent rTMS treatment additionally.Muscle tone, plantar pressure, plantar area and GMFM-88 of the children in two groups were evaluated before and after treatment. Results After treatment, muscle tone (t=4.521,3.789), plantar pressure (t=8.412,7.354), plantar area (t=4.585,10.251)and GMFM-88 D and E scores (t=11.247,9.254,8.738,6.254) in both groups were significantly improved compared with baseline (P<0.05).After treatment, muscle tone of children in the study group was significantly lower than that of the control group, plantar pressure, plantar area, GMFM-88 D and E scores of study group were significantly higher than those in control group (t=7.213, 5.134, 4.233, 8.646, 7.463, P<0.05). Conclusion rTMS combined with ESW therapy can effectively improve the lower limb motor function and gait performance in children with hemiplegia.