脑瘫患儿融合式教育结合康复训练的研究△

A study on integrated education and rehabilitation training for cerebral palsy in children

摘要:

［目的］ 观察融合式教育结合康复训练对改善脑瘫 （cerebral palsy, CP） 儿童运动及认知能力、手功能障碍的作用。 ［方法］ 2019 年 1 月—2020 年 12 月本院康复治疗中心收治的 60 例 CP 患儿纳入本研究。随机分为融合组 30 例和常规组 30 例，分别给予融合式教育结合常规康复训练和单纯常规康复训练。评估干预结果并作两组间比较。［结果］两组患者均顺利完成干预全过程。随访 12~24 个月，干预后，融合组粗大运动功能分级系统（gross motor function classification system, GMFCS）、儿童手功能分级系统 （manual ability classification system, MACS）、功能独立性测量儿童版量表 （functional independence measure, WeeFIM）［7］ 和日常生活运动能力（activities of daily living, ADL）均显著提高（P<0.05），而常规组仅 WeeFIM 评分、ADL 评分显著增加（P<0.05）。干预前，两组上述指标的差异均无统计学意义（P>0.05），干预 3 个月后，融合组 WeeFIM 评分、ADL 评分显著优于常规组（P<0.05），干预 6 个月后，融合组 GMFCS 评级、MACS 评级、WeeFIM 评分、ADL 评分均显著优于常规组（P< 0.05）。［结论］融合式康复教育结合康复训练更有利于改善适龄脑瘫患儿运动功能、认知能力、生活自理能力等。

Abstract:

[Objective] To observe the effect of integrated education combined with rehabilitation training on improving motor and cog- nitive abilities and hand dysfunction for cerebral palsy (CP) in children. [Methods] A total of 60 children who were admitted into the reha- bilitation treatment center of our hospital from January 2019 to December 2020 were included in this study. The children were randomly di- vided into the integrated group (n=30) and the conventional group (n=30) , and were given the integrated education combined with routine rehabilitation training and the routine rehabilitation training only, respectively. The intervention consequences were evaluated and com- pared between the two groups. [Results] All children in both groups had the whole process of intervention completed successfully, and fol- lowed up for 12 to 24 months. The integrated group got significantly improvement in terms of GMFCS grade, MACS grade, WeeFIM score and ADL score (P＜0.05) , while the conventional group had significant improvements in WeeFIM score and ADL score only after interven- tion compared with those before intervention (P＜0.05) . Although there was no significant difference in the above items between the two groups before intervention (P＞0.05) , the integrated group proved significantly superior to the conventional group in terms of the WeeFIM score and ADL score 3 months after intervention (P＜0.05) , whereas in terms of GMFCS grade, MACS grade, WeeFIM and ADL scores 6 months after intervention (P＜0.05) . [Conclusion] The integrated education combined with rehabilitation training is more beneficial to im- prove motor function, cognitive ability and self-care ability of CP children in appropriate age.