肌内效贴扎对小儿脑瘫核心肌群的影响及异常步态的预防作用

徐艳; 吴锋锋; 何凤翔

doi:10.16766/j.cnki.issn.1674-4152.002155

肌内效贴扎对小儿脑瘫核心肌群的影响及异常步态的预防作用

doi: 10.16766/j.cnki.issn.1674-4152.002155

湖州市中心医院，湖州师范学院附属中心医院康复科，浙江湖州 313000

基金项目:

浙江省医药卫生科技计划项目 2018KY779

详细信息

通讯作者:
徐艳, E-mail: xudaofen1985@163.com

中图分类号: R493 R729
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- 文章访问数: 110
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- 被引次数: 0
出版历程
- 收稿日期: 2020-09-29
- 网络出版日期: 2022-02-15

Effect of kinesio taping on the core muscle groups of children with cerebral palsy and the prevention of abnormal gait

Department of Rehabilitation, Central Hospital, Huzhou Normal University, Huzhou, Zhejiang 313000, China

摘要

摘要: 目的探讨肌内效贴扎对小儿脑瘫核心肌群的影响及异常步态的预防作用，为临床预防小儿脑瘫步态异常提供参考。方法选取2017年1月—2019年5月湖州市中心医院收治的50例小儿脑瘫患儿，采用随机数字表法分为2组，每组25例。对照组给予常规康复训练，观察组在此基础上给予肌内效贴扎，2组均干预2个月。采用平衡训练检测仪评估2组睁眼时躯干稳定控制指标，比较2组干预前后核心肌群肌力变化、Berg平衡量表(BBS)评分、步态评估量表(TGA)、步态测试数据、综合痉挛量表(CSS)、改良巴氏指数评定表(MBI)、粗大运动功能评估表(GMFM-88)评分。结果干预后观察组躯干平均压力中心前后和左右方向位移标准差、前后和左右方向平均运动速度低于对照组，腹直肌、竖脊肌、臀大肌、髂腰肌肌力评分高于对照组(均P＜0.05)；干预后观察组BBS、TGA评分分别为(35.51±3.67)、(10.23±1.13)分，高于对照组的(30.49±2.98)、(7.49±1.08)分(均P＜0.05)；干预后观察组左侧步长、右侧步长、左侧步速、GMFM-88量表A~E评分高于对照组，步宽低于对照组(均P＜0.05)；干预后观察组CSS评分[(7.48±1.27)分]低于对照组的(9.11±1.18)分，MBI评分[(80.67±7.08)分]高于对照组的(72.39±7.19)分(均P＜0.05)。结论肌内效贴扎能提高脑瘫患儿躯干稳定性控制能力，增加核心肌群肌力，改善机体平衡能力，预防、纠正步态异常，提高患儿日常生活能力与粗大运动功能。
- 肌内效贴扎 /
- 小儿 /
- 脑瘫 /
- 核心肌群 /
- 异常步态
Abstract: Objective To investigate the effect of kinesio taping on the core muscle groups of children with cerebral palsy and its preventive effect of abnormal gait so as to provide a reference for the clinical prevention of abnormal gait in children with cerebral palsy. Methods Fifty children with cerebral palsy admitted at Huzhou Central Hospital from January 2017 to May 2019 were selected. They were divided into two groups according to simple randomisation, with 25 cases in each group. The control group was given routine rehabilitation training, whereas the observation group was given kinesio taping. The two groups were intervened for 2 months, and a balance training detector was used to evaluate the trunk stability control indicators of the two groups when the eyes were opened. The core muscle strength changes, Berg Balance Scale (BBS) score, Tinetti Gait Analysis (TGA) and gait test data, comprehensive spasticity scale (CSS), modified Barthel index (MBI) and gross motor function evaluation form (GMFM-88) before and after intervention were compared between the two groups. Results After intervention, the standard deviations of the displacement in the observation group before and after COP and the left and right directions, the average movement speed of the front and rear and the left and right directions were lower than those in the control group. The rectus abdominis, erector spinae, gluteus maximus and iliopsoas muscle scores of the observation group were higher than those of the control group (all P < 0.05). The BBS and TGA scores of the observation group after intervention were (35.51±3.67) and (10.23±1.13) points, which were higher than those of the control group (30.49±2.98) and (7.49±1.08) points, respectively (all P < 0.05). After intervention, the left-side step length, right-side step length, left-side step speed and GMFM-88 scale A-E scores of the observation group were higher than those of the control group, and the step width of the observation group was lower than that of the control group (all P < 0.05). After intervention, the CSS score and MBI score of the observation group (7.48±1.27 and 80.67±7.08) were lower and higher than those of the control group (9.11±1.18 and 72.39±7.19), respectively (all P < 0.05). Conclusion Kinesio taping can improve the trunk stability control ability of children with cerebral palsy, increase the muscle strength of the core muscle group, improve the body's balance ability, prevent and correct gait abnormalities and improve children's daily life ability and gross motor function.
- Kinesio taping /
- Children /
- Cerebral palsy /
- Core muscle groups /
- Abnormal gait

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表 1 2组脑瘫患儿临床资料对比

组别	例数	男/女 (例)	年龄 (x±s, 岁)	体重 (x±s, kg)	GMFCS分级[例(%)]			脑瘫类型[例(%)]
组别	例数	男/女 (例)	年龄 (x±s, 岁)	体重 (x±s, kg)	Ⅰ	Ⅱ	Ⅲ	痉挛型	不随意运动型	共济失调型	混合型
观察组	25	12/13	5.62±1.75	18.69±5.11	7(28.00)	12(48.00)	6(24.00)	15(60.00)	5(20.00)	3(12.00)	2(8.00)
对照组	25	14/11	5.57±1.69	19.24±5.08	9(36.00)	11(44.00)	5(20.00)	17(68.00)	1(4.00)	4(16.00)	3(12.00)
统计量		0.321^a	0.103^b	0.382^b	0.549^c			3.135^a
P值		0.571	0.919	0.704	0.583			0.371
注：^a为χ²值，^b为t值，^c为Z值。

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表 2 2组脑瘫患儿躯干稳定控制指标比较(x±s)

组别	例数	前后位移(mm)		左右位移(mm)		前后平均运动速度(mm/s)		左右平均运动速度(mm/s)
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后	干预前	干预后
观察组	25	2.48±1.27	1.12±0.50^a	3.10±1.24	1.39±0.62^a	5.88±1.96	3.26±1.02^a	5.91±1.36	3.16±0.98^a
对照组	25	2.50±1.19	1.54±0.45^a	3.06±1.18	1.87±0.58^a	5.92±1.89	4.17±0.94^a	5.86±1.42	4.27±0.82^a
t值		0.058	3.122	0.117	2.827	0.074	3.280	0.127	4.343
P值		0.954	0.003	0.908	0.007	0.942	0.002	0.899	＜0.001
注：与同组干预前比较，^aP＜0.05。

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表 3 2组脑瘫患儿核心肌群肌力比较(x±s，分)

组别	例数	腹直肌		竖脊肌		臀大肌		髂腰肌
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后	干预前	干预后
观察组	25	1.22±0.18	3.61±0.25^a	1.31±0.21	3.34±0.20^a	1.17±0.22	3.72±0.19^a	1.25±0.26	3.24±0.23^a
对照组	25	1.25±0.20	3.04±0.22^a	1.28±0.24	3.11±0.18^a	1.21±0.20	3.15±0.21^a	1.27±0.24	3.00±0.17^a
t值		0.558	8.558	0.470	4.274	0.673	10.064	0.283	4.196
P值		0.580	＜0.001	0.640	＜0.001	0.504	＜0.001	0.779	＜0.001
注：与同组干预前比较，^aP＜0.05。

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表 4 2组脑瘫患儿BBS、TGA评分比较(x±s，分)

组别	例数	BBS评分		TGA评分
组别	例数	干预前	干预后	干预前	干预后
观察组	25	20.15±5.18	35.51±3.67^a	4.97±1.25	10.23±1.13^a
对照组	25	20.08±4.97	30.49±2.98^a	5.03±1.32	7.49±1.08^a
t值		0.049	5.309	0.165	8.765
P值		0.961	＜0.001	0.870	＜0.001
注：与同组干预前比较，^aP＜0.05。

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表 5 2组脑瘫患儿步态测试数据比较(x±s)

组别	例数	左侧步长(cm)			右侧步长(cm)			左侧步速(cm/s)			右侧步速(cm/s)
组别	例数	干预前	干预后		干预前	干预后		干预前	干预后		干预前	干预后
观察组	25	37.20±5.86	39.78±1.46^a		38.86±7.05	40.98±3.15^a		37.03±6.82	39.87±2.42^a		84.15±8.33	88.15±3.65^a
对照组	25	37.32±6.15	38.11±1.95^a		39.14±6.82	39.35±2.12		36.95±7.34	37.24±2.09		84.22±9.51	87.69±4.91^a
t值		0.071	3.428		0.143	2.147		0.040	4.113		0.028	0.376
P值		0.944	0.001		0.887	0.037		0.968	＜0.001		0.978	0.709

组别	例数	左侧步频(step/min)				右侧步频(step/min)				步宽(cm)
组别	例数	干预前	干预后	干预前		干预后	干预前	干预后		干预前	干预后
观察组	25	137.66±6.48		139.15±7.44		137.69±7.35		138.95±7.41		15.51±4.69		13.08±1.55^a
对照组	25	138.04±7.52		139.06±7.50		137.75±7.28		138.86±7.36		14.42±5.19		14.40±1.36
t值		0.191		0.043		0.029		0.043		0.779		3.201
P值		0.849		0.966		0.977		0.966		0.440		0.002
注：与同组干预前比较，^aP＜0.05。

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表 6 2组脑瘫患儿CSS、MBI评分比较(x±s，分)

组别	例数	CSS评分		MBI评分
组别	例数	干预前	干预后	干预前	干预后
观察组	25	12.25±2.33	7.48±1.27^a	54.45±10.23	80.67±7.08^a
对照组	25	12.17±2.21	9.11±1.18^a	55.16±11.05	72.39±7.19^a
t值		0.125	4.701	0.036	4.103
P值		0.901	＜0.001	0.815	＜0.001
注：与同组干预前比较，^aP＜0.05。

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表 7 2组脑瘫患儿GMFM-88评分比较(x±s，分)

组别	例数	A		B		C		D		E
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后	干预前	干预后	干预前	干预后
观察组	25	32.26±5.11	40.24±4.79^a	35.46±7.59	46.37±6.98^a	25.47±6.33	36.44±5.29^a	20.40±5.15	29.72±4.25^a	30.45±8.32	46.68±8.44^a
对照组	25	33.47±4.86	36.38±4.15^a	35.08±8.13	41.69±7.23^a	26.02±6.19	32.01±5.73^a	20.62±5.07	26.01±4.16^a	31.24±9.17	41.11±7.39^a
t值		0.858	3.045	0.171	2.329	0.311	2.840	0.104	3.119	0.319	2.483
P值		0.395	0.004	0.865	0.024	0.757	0.007	0.918	0.003	0.751	0.017
注：与同组干预前比较，^aP＜0.05。

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