神经松动术改善痉挛型脑瘫患儿下肢运动功能疗效观察.docVIP

神经松动术改善痉挛型脑瘫患儿下肢运动功能疗效观察 　　摘要：目的 观察神经松动术对痉挛型脑瘫患儿下肢运动功能的疗效。方法 25例痉挛型脑瘫患儿随机分为对照组（n=13）和观察组（n=12）。两组常规治疗相同，观察组同时运用神经松动术进行治疗。分别于治疗前和治疗4 w后采用腓肠肌痉挛评分（改良Ashworth 分值，MAS）、踝关节主动背屈活动度（ROM）和粗大运动功能量表（GMFM-88）之D区（站立）、E区（走跑跳）评定。结果 治疗4 w后两组上述指标均较治疗前有改善（P0.01），且观察组MAS、ROM和GMFM-88之D区和E区评分均比对照组改善（P0.05）。结论 神经松动术配合康复训练能降低痉挛型脑瘫患儿下肢肌张力，增加踝关节活动度和提高下肢运动功能。 　　关键词：神经松动术；脑性瘫痪；痉挛型；下肢运动功能 　　Effect of Nerve Mobilization on Motor Function of Lower Extremities in Children with Spastic Cerebral Palsy 　　MOU Yang1，LUO Ya-ling1，ZENG Xiang-bin2，LI Wei2，ZHANG Rong2 　　（1.Sichuan Vocational College of Health and Rehabilitation，Zigong 643000， Sichuan ，China；2.Department of Rehabilitation Medicine，Zigong First Peoples Hospital，Zigong 643000， Sichuan ，China） 　　Abstract：Objective To observe the effect of nerve mobilization on motor function of lower extremities in children with spastic cerebral palsy （CP）. Methods Twenty-five spastic CP children were randomly divided into control group （n=13） and observation group （n=12）. Two groups were given conventional rehabilitation training， and observation group received treatment of nerve mobilization additionally. Modified Ashworth Scale （MAS）， range of motion （ROM） of ankle active dorsiflexion motion and D and E domains of Gross Motor Function Measure （GMFM-88） were evaluated at the beginning and at the end of the 4th week of treatment course respectively. Results The outcomes were improved compared with the ones of pre-treatment （P0.01）， and improved more in the treatment group （P0.05）. Conclusion Nerve mobilization in combination with rehabilitation therapy in the treatment for children with spastic CP can decrease the muscle tone of lower limbs and improve the range of ankle active motion， as well as the motor function of lower extremities. 　　Key words：Nerve mobilization； Cerebral palsy；Spastic；Lower extremity motor function 　　痉挛型脑瘫患儿常因为下肢张力过高或不平衡出现屈髋、屈膝和足内外翻等，引起站立和步态严重异常[1]，直接影响下肢运动功能，且在康复过程中容易造成损伤[2]。神经松动术是一种相对较新的徒手治疗方法[3]，它是以神经动力学为基础，通过多关节的运动，从而将力直接作