基于ICF理念下的家庭式手工训练对痉挛型偏瘫脑瘫患儿功能独立性的影响

目的　探索基于国际功能、残疾和健康分类（ICF）理念下的家庭式手工训练对痉挛型偏瘫脑瘫患儿功能独立性的影响。方法　选取2021年3月至9月广州市社会福利院康复医院康复科收治的50例6～12岁存在手运动功能障碍的痉挛型偏瘫脑瘫患儿作为研究对象，采用随机数字表法将其分为试验组与对照组，每组各25例。试验组男15例、女10例，年龄（8.2±1.0）岁；对照组男14例、女11例，年龄（8.6±0.6）岁。使用《国际功能、残疾和健康分类（儿童和青少年版）》（ICF-CY）核心分类组合简明通用版对两组患儿进行初评，与护理员（监护人角色）共同制定针对性的综合康复方案，并根据康复方案对护理员进行相应培训。试验组护理员对患儿每天进行40 min手工训练+常规康复治疗，对照组护理员对患儿每天进行常规康复治疗，持续干预3个月。比较两组患儿治疗前后的功能独立性。采用χ²检验、t检验。结果　两组患儿治疗前儿童功能独立性评定量表（WeeFIM）评分比较，差异无统计学意义（P>0.05）；治疗3个月后，试验组WeeFIM评分明显高于对照组［（75.76±5.07）分比（61.24±3.06）分］，且两组患儿治疗后WeeFIM评分均明显高于治疗前［（75.76±5.07）分比（49.84±3.95）分、（61.24±3.06）分比（49.84±3.46）分］，差异均有统计学意义（均P<0.05）；试验组治疗前后差值［（25.92±3.39）分］与对照组［（11.40±2.78）分］比较，差异有统计学意义（P<0.05）。结论　手工训练对痉挛型偏瘫脑瘫患儿功能独立性有较好改善，可适当将手工训练引入居家及社区康复治疗中。

Effect of family manual training on functional independence in childrenwith spastic hemiplegia cerebral palsy under the ICF concept

 Objective　To explore the effectof family manual training on functional independence in children with spastichemiplegia cerebral palsy under the ICF (International Classification ofFunctioning, Disability and Health) concept. Methods　Fifty children with spastic hemiplegia cerebral palsy and hand motordysfunction aged 6-12 years admitted to Department of Rehabilitation, GuangzhouSocial Welfare Institute Rehabilitation Hospital from March 2021 to September2021 were enrolled in the study. They were divided into an experimental groupand a control group according to the random number table method, with 25 casesin each group. In the experimental group, there were 15 males and 10 females,aged (8.2±1.0) years; in the control group, there were 14 males and 11 females,aged (8.6±0.6) years. The concise general version of the InternationalClassification of Functioning, Disability and Health (Children and Youthversion) (ICF-CY) core classification combination was used for the initialassessment of the two groups, targeted comprehensive rehabilitation programswere formulated together with the caregivers (guardian role), and thecaregivers were correspondingly trained according to the rehabilitationprograms. The children in the experimental group were given 40 minutes ofmanual training and routine rehabilitation treatment every day, and thechildren in the control group were given routine rehabilitation treatment for 3months. The functional independence of the two groups were compared before andafter treatment. Chi-square test and t test were used. Results　There was nostatistically significant difference in the Functional Independence Measure forChildren (WeeFIM) score between the two groups before treatment (P>0.05). After 3 months of treatment,the WeeFIM score of the experimental group was significantly higher than thatof the control group [(75.76±5.07) points vs. (61.24±3.06) points], and theWeeFIM scores in the two groups were significantly higher than those beforetreatment [(75.76±5.07) points vs. (49.84±3.95) points, (61.24±3.06) points vs.(49.84±3.46) points], with statistically significant differences (all P<0.05). There was statisticallysignificant difference in the difference of WeeFIM score before and aftertreatment between the experimental group [(25.92±3.39) points] and the controlgroup [(11.40±2.78) points] (P<0.05). Conclusion　Manual training canimprove the functional independence in children with spastic hemiplegiccerebral palsy, and manual training can be appropriately introduced into homeand community rehabilitation treatment.