全身振动训练对1～3岁痉挛型脑瘫患儿下肢运动功能的影响*
Effects of whole body vibration training on lower limb motor function in children aged 1～3 years with spastic cerebral palsy

目的:观察全身振动训练对1～3岁痉挛型脑瘫儿童下肢运动功能的影响。方法:选取1～3岁痉挛型脑瘫患儿75例,随机分为全身振动训练组(n=38)和常规训练组(n=37),常规训练组给予12周的运动疗法、石蜡疗法及神经肌肉电刺激疗法; 全身振动训练组在常规训练的基础上给予12周的全身振动训练。采用改良Tardieu量表(MTS)、表面肌电图(sEMG)被动状态数值对患儿治疗前后下肢痉挛程度进行评价,采用粗大运动功能测试量表-88(GMFM-88)、Berg平衡量表(BBS)对患儿治疗前后的粗大运动功能及平衡功能进行评价。结果:治疗前两组患儿MTS评分、MTS踝关节角度R1、R2、sEMG被动状态数值、GMFM-88评分、BBS评分差异无统计学意义(P>0.05); 治疗后,全身振动训练组MTS评分、MTS踝关节角度R1、R2、sEMG被动状态数值、GMFM-88、BBS评分较常规训练组明显改善(P<0.05)。结论:全身振动训练可有效缓解1～3岁痉挛型脑瘫儿童的下肢痉挛,改善其粗大运动及平衡功能。
Aim: To observe the effect of whole body vibration training on lower limb motor function in children aged 1～3 years with spastic cerebral palsy.Methods: Seventy-five children aged 1～3 years with spastic cerebral palsy were selected and randomly divided into the whole body vibration training group(n=38)and conventional training group(n=37). The conventional training group received conventional physical therapy, paraffin therapy and neuromuscular electrical stimulation for twelve weeks. The whole body vibration training group received whole body vibration training on the basis of the conventional training for twelve weeks.The modified tardieu scale(MTS), the values in the passive state measured by surface electromyography(sEMG)were used to evaluate the degree of spasticity in children before and after treatment. The 88-item version of the gross motor function measure(GMFM-88)and Berg balance scale(BBS)were respectively used to evaluate the gross motor function and balance function before and after treatment.Results: Before treatment, there were no significant differences in MTS score, ankle joint angles R1 and R2 in MTS, the values in the passive state measured by sEMG, GMFM-88 score, BBS score between the two groups(P>0.05). After treatment, all the indexes were significantly improved in the whole body vibration training group compared with the conventional training group(P<0.05).Conclusion: Whole body vibration training can effectively relieve spasticity of lower limbs,and improve gross motor and balance function in children aged 1～3 years with spastic cerebral palsy