《中国康复理论与实践》

《中国康复理论与实践》 ›› 2010, Vol. 16 ›› Issue (2): 174-176.

• 论文 • 上一篇    下一篇

改良强制性诱导运动治疗儿童偏瘫个案报道

邢春燕，孙克兴   

  1. 上海中医药大学针灸推拿学院，上海市 201203。
  • 收稿日期:2009-07-16 修回日期:2009-10-13 出版日期:2010-02-25 发布日期:2010-02-25
  • 通讯作者: 孙克兴

Modified Constraint Induced Movement Therapy for Children with Post-traumatic Brain Syndrome: a Case Report

XING Chun-yan, SUN Ke-xing.   

  1. Shanghai Putuo Central Hospital, the Affiliated Hospital of Acupuncture and Moxibustion College of Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
  • Received:2009-07-16 Revised:2009-10-13 Published:2010-02-25 Online:2010-02-25

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摘要： 目的为儿童偏瘫患者的上肢功能康复训练提供一种可资借鉴的模式。方法选择1例5岁的脑外伤后遗右侧偏瘫患儿，监护人知情同意。主要参照强制性诱导运动疗法的基本原则，限制健侧上肢活动,集中、反复、大量地对患肢进行训练。包括针对性推拿和作业治疗(30 min/次)、家庭功能性、文娱性活动训练，1次/d，5次/周，3周为1个疗程。治疗期间用低温板塑的限制性器具限制左上肢(健侧)，10 h/d。采用Peabody运动发育量表(PDMS-2)、上田敏偏瘫上肢功能评价表、Brunnstrom偏瘫手功能评价、治疗师日志并参考家长反应来评估疗效。结果治疗后患肢的主动性有明显提高，PDMS-2评定明显提高，上田敏偏瘫上肢功能评价表、Brunnstrom偏瘫手功能评价均有改善。结论改良强制性诱导运动疗法对偏瘫儿童患侧上肢的功能恢复有积极的影响。

关键词: 儿童, 偏瘫, 康复, 运动疗法, 改良强制性诱导运动

Abstract: ObjectiveTo explore a suitable model for the upper-limb rehabilitation of children with post-traumatic brain syndrome following hemiplegia.MethodsA 5-year-old child with right hemiplegia, post-traumatic brain syndrome, was selected under certain information consent of his guardian. Training program was strictly executed in compliance with constraint-induced movement therapeutic principles to restrain the non-involved upper extremity while intensively perform abundant and repetitive training for the involved hand. Specific training prescription is targeted massage plus occupational therapy together 30 min once and functional plus entertainment training at home for 3 weeks, once a day, 5 days a week. Time of restraining non-involved extremity is 10 hours a day. Assessment of therapeutic effects was through following forms, Peabody Developmental Motor Scales-2(PDMS-2), The Hemiplegic Upper Limb Function Evaluation of Ueda, Brunnstrom Scale and therapist's diary.ResultsThe capability of involved hand was improved obviously. The score of the PDMS-2 enhanced. The outcome judged by The Hemiplegic Upper Limb Function Evaluation of Ueda and Brunnstrom Scale was much better than before.ConclusionModified constraint-induced movement therapy has positive effects on functional promotion of upper extremity of children with hemiplegia.

Key words: children, hemiplegia, rehabilitation, physical therapy, modified constraint-induced movement therapy