体外冲击波治疗脑瘫肌痉挛的疗效观察

目的:观察体外冲击波对脑瘫患儿小腿三头肌痉挛的疗效和安全性。方法:脑瘫肌痉挛患儿50例分为观察组24例和对照组26例,2组均给予常规康复治疗,观察组加用冲击波治疗,治疗前后对2组患儿的被动关节活动度(PROM)、改良的Asworth分级(MAS)、粗大运动功能评分(GMFM)、足底支持面积和足底压力进行评定。结果:观察组治疗1周及4周后,小腿三头肌MAS评分较治疗前明显下降(P<0.05),且呈逐渐下降趋势(P<0.05),且各时间段各项评分均更低于对照组(P<0.05);对照组治疗1周后,小腿三头肌MAS评分及踝关节PROM与治疗前比较差异无统计学意义,治疗4周后,小腿三头肌MAS评分较治疗前及治疗1周时明显下降(P<0.05)。观察组治疗1周及4周后,踝关节PROM、GMFM评分、足底面积及足底压力均较治疗前明显增加(P<0.05),且呈逐渐上升趋势(P<0.05),且各时间段各项评分均更高于对照组(P<0.05);对照组治疗1周后,踝关节PROM、GMFM评分、足底面积及足底压力与治疗前比较差异无统计学意义,治疗4周后,踝关节PROM、GMFM评分、足底面积及足底压力均较治疗前及治疗1周时明显增加(P<0.05)。结论:体外冲击波治疗可以降低脑瘫患儿小腿三头肌张力,缓解肌肉痉挛,改善其粗大运动功能。

Curative effect of extracorporeal shock wave treatment for muscle spasticity in children with cerebral palsy

Objective: To investigate the curative effects and security of extracorporeal shock wave treatment for muscle spasticity in children with cerebral palsy. Methods: Fifty children with cerebral palsy of muscle spasticity were divided into the observation group (n=24) and control group (n=26). Two groups received routine rehabilitation. The observation group was given extracorporeal shock wave treatment additionally. Before and after treatment, muscle spasticity was evaluated by passive range of motion (PROM), modified Ashworth scale (MAS), Gross Motor Function Measure (GMFM), and foot contact area. Results: One week and 4 weeks after treatment, the MAS scores of triceps surae muscle were decreased in the observation group as compared with those before treatment (P<0.05), showing a gradually descent trend (P<0.05), and the score of every item at any time point was significantly different as compared with that in the control group (P<0.05). One week after treatment, the MAS scores of triceps surae muscle in the control group showed no statistically significant difference from those before treatment. Four weeks after treatment, the scores of MAS in control group were decreased as compared with those pretreatment and one week after treatment (P<0.05). One week and 4 weeks after treatment, the scores of ankle PROM, Gross Motor Function Measure, foot contact area, and foot pressure were increased in the observation group as compared with those before treatment (P<0.05), showing a gradually descent trend (P<0.05). The score of every item in the observation group was increased as compared with the control group at any time point (P<0.05). One week after treatment, the scores of ankle PROM, Gross Motor Function Measure, foot contact area, and foot pressure showed no statistically significant difference in the control group as compared with those before treatment. Four weeks after treatment, the scores of ankle PROM, Gross Motor Function Measure, foot contact area, and foot pressure were increased in the control group as compared with those before treatment and one week after treatment (P<0.05). Conclusion: Extracorporeal shock wave treatment can decrease triceps surae muscle tension, release muscle spasm, and improve gross motor function.