基于ICF-CY平衡姿态悬吊治疗方案的设计

doi:10.3969/j.issn.1006-9771.2023.11.009

《中国康复理论与实践》 ›› 2023, Vol. 29 ›› Issue (11): 1316-1326.doi: 10.3969/j.issn.1006-9771.2023.11.009

基于ICF-CY平衡姿态悬吊治疗方案的设计

王玉昌¹, 吴月¹, 付亏杰¹, 王正辉¹, 王亚洲¹, 郭学军¹, 庞伟²()

1.新乡医学院第一附属医院，河南新乡市 453100
2.佳木斯大学第三附属医院，黑龙江佳木斯市 154002

收稿日期:2023-08-04 修回日期:2023-09-15 出版日期:2023-11-25 发布日期:2023-11-30
通讯作者: 庞伟，男，主任医师，教授，硕士研究生导师。E-mail： pangwei76@aliyun.com
作者简介:王玉昌(1987-)，男，汉族，山东曹县人，硕士研究生，主治医师，主要研究方向：神经智能康复研发与实践。
基金资助:
1. 河南省医学科技攻关计划联合共建项目(2018020354);2.新乡医学院第一附属医院青年培育基金项目(QN-2019-B12);4.黑龙江省自然科学基金联合引导项目(LH2022H092)

Development of a nature posture treatment suspension therapy based on ICF-CY

WANG Yuchang¹, WU Yue¹, FU Kuijie¹, WANG Zhenghui¹, WANG Yazhou¹, GUO Xuejun¹, PANG Wei²()

1. The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan 453100, China
2. The Third Affiliated Hospital of Jiamusi University, Jiamusi, Heilongjiang 154002, China

Received:2023-08-04 Revised:2023-09-15 Published:2023-11-25 Online:2023-11-30
Contact: PANG Wei, E-mail： pangwei76@aliyun.com
Supported by:
Henan Medical Science and Technology Research Plan Joint Construction Project(2018020354);the First Affiliated Hospital of Xinxiang Medical University Youth Cultivation Fund(QN-2019-B12);Xinxiang Key Laboratory of Rehabilitation Medicine(3.新乡市康复医学重点实验室项目);Heilongjiang Natural Science Foundation Joint Guidance Project(LH2022H092)

摘要/Abstract

摘要：

目的基于《国际功能、残疾和健康分类(儿童和青少年版)》(ICF-CY)理论框架开发平衡姿态训练(NPT)悬吊疗法，并观察其在神经发育障碍性疾病中的临床应用。

方法成立ICF-CY理论小组和NPT悬吊疗法治疗小组，理论小组检索数据库，提取悬吊疗法高频词，将高频词与ICF-CY相关类目进行匹配，得出NPT悬吊疗法ICF-CY理论框架。治疗小组依据理论框架制定康复流程、训练条目，组成训练池。选择2019年10月至2022年10月新乡医学院第一附属医院门诊或住院的0~6岁神经发育障碍并发运动障碍患儿110例，随机分为对照组(n = 55)和观察组(n = 55)，对照组采用常规神经发育学疗法，观察组选择基于ICF-CY的NPT悬吊疗法，共1周。观察患者满意度、接受度和不良事件发生率。

结果对照组脱落2例，观察组脱落4例。观察组满意度98% (50/51)，接受度96% (49/51)，不良事件1件；对照组满意度、接受度均为100%，无不良事件发生。两组满意度、接受度和不良事件发生率均无显著性差异(P > 0.05)。

结论基于ICF-CY理论框架的NPT悬吊疗法安全可靠，临床接受度良好。

关键词: 儿童, 神经发育障碍, 悬吊疗法, 平衡姿态训练, 国际功能、残疾和健康分类(儿童和青少年版)

Abstract:

Objective To develop a rehabilitation program of nature posture treatment (NPT) suspension therapy based on the International Classification of Functioning, Disability and Health-Children and Youth version (ICF-CY) framework, and apply it to neurodevelopmental disorders.

Methods The ICF-CY theoretical group (group A) and NPT suspension therapy group (group B) were established. Group A searched literature from common databases, to extract high-frequency words related to suspension therapy and match with categories of ICF-CY, to develop ICF-CY theoretical framework of the NPT suspension therapy. Group B developed specific rehabilitation procedures and training items based on the framework to compose the training pool. A total of 110 children aged less than six years with neurodevelopmental disorders and associated motor impairments were selected from outpatient or inpatient of the First Affiliated Hospital of Xinxiang Medical University, between October, 2019 and October, 2022. They were randomly divided into control group (n= 55) and clinical group (n= 55), who received routine neurodevelopmental therapy and NPT suspension therapy program based on ICF-CY, respectively, for a week. The incidence of satisfaction, acceptance and adverse events were observed.

Results Two cases in the control group and four cases in the clinical group dropped down. For the clinical group, the incidence of satisfaction was 98% (50/51), with acceptance of 96% (49/51), and one adverse event occurred. For the control group, the incidence of both the satisfaction and acceptance was 100%, and no adverse event occurred. There was no significant difference in the incidence of satisfaction, acceptance and the adverse event (P> 0.05).

Conclusion The NPT suspension therapy program based on the ICF-CY framework is safe and acceptable for children with neurodevelopmental disorders.

Key words: children, neurodevelopmental disorders, suspension therapy, nature posture treatment, International Classification of Functioning, Disability and Health-Children and Youth version

中图分类号:

R748

王玉昌, 吴月, 付亏杰, 王正辉, 王亚洲, 郭学军, 庞伟. 基于ICF-CY平衡姿态悬吊治疗方案的设计[J]. 《中国康复理论与实践》, 2023, 29(11): 1316-1326.

WANG Yuchang, WU Yue, FU Kuijie, WANG Zhenghui, WANG Yazhou, GUO Xuejun, PANG Wei. Development of a nature posture treatment suspension therapy based on ICF-CY[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(11): 1316-1326.

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ICF分类	一级水平	二级水平	三级水平
身体功能(b)	精神功能(b1)	b110、b114、b130、b140、b156	b1100、b1101、b1141、b1144、b1300、b1301、b1400、b1560、b1561、b1564、b1565
	感觉功能(b2)	b210、b235、b240	b2100、b2350、b2351、b2352、b2401、b2402
	发音与言语功能(b3)	b310、b330	b3100、b3300
	呼吸功能(b4)	b455	b4550
	神经肌肉骨骼和运动有关功能(b7)	b715、b720、b730、b735、b740、b760	b7151、b7201、b7303、b7304、b7305、b7306、b7350、b7401、b7602、b7603
身体结构(s)	与运动有关结构(s7)	s720、s730、s740、s750、s760	s7200、s7201、s7202、s7203、s7208、s7209、s7300、s7301、s7302、s7308、s7309、s7400、s7401、s7402、s7403、s7408、s7409、s7500、s7501、s7502、s7508、s7509、s7600、s7601、s7602、s7608、s7609
活动与参与(d)	一般任务与要求(d2)	d210、d220	d2100、d2200
活动与参与(d)	活动(d4)	d410、d415、d420、d430、d445、d450、d455、d880	d4100、d4101、d4102、d4103、d4104、d4105、d4106、d4107、d4108、d4109、d4150、d4151、d4152、d4153、d4154、d4155、d4158、d4159、d4200、d4201、d4202、d4208、d4209、d4300、d4450、d4458、d4502、d4503、d4550、d4551、d8800
环境因素(e)	产品与技术(e1)	e115、e120	-
	支持与相互联系(e3)	e310、e355	-
	态度(e4)	e410	-

代码	条目名称	ICF-CY编码
a	骨盆的结构：骨盆回旋	s740
b	肌肉力量功能：伸髋肌群训练	b7303
c	肌肉力量功能：腹肌力量训练	b7301、b7305、d4150、d4158、d4458
d	肌肉力量功能：侧屈肌群训练	b7305、d4158、d4458
e	头控移动训练	d4100、d4155、b7305
f	翻身移动训练	d4107、b7304、b7305
g	坐位移动训练	d4103、d4150、d4153、b7300、b7305
h	膝立位移动训练	d4102、d4152、d4302、b7304、b7305
i	坐立移动训练	d4103、d4104、d4154、d4401、d4450、b7300、b7303、b7305、b7306
j	蹬踏训练	d4106、d4154、b7303、b7305
k	跪立位移动训练	d4102、d4106、d4152、d4154、b7303、b7305
l	大鹏展翅	d8800、d4201、d4452、b7304、b7305
m	单侧肢体够物	d8800、d4150、d4455、b7301、b7304、b7305
n	空中踏步	d8800、d4108、d4154、d4155、d4455、b7303、b7305、b7401、b7600
o	攀爬游戏	d8800、d4104、d4106、d4153、d4154、d4208、d4401、d4551、b7304、b7305、b7401、b7602、b7603
p	医疗环境干预	e355
q	家庭态度干预	e310、e410
r	个人辅助支具干预	e115

障碍类型	障碍频率/n	匹配训练条目代码	障碍类型	障碍频率/n	匹配训练条目代码
蹲伏步态	8	b/g/h/j/p/q/r	剪刀步态	2	a/i/j/p/q/r
躯干肌张力障碍	7	l/p/q/r	蹒跚步态	2	j/k/p/q/r
步态廓清障碍	7	n/p/q	上肢够物障碍	2	l/m/p/q
跑跳困难	5	o/p/q/r	爬行障碍	1	b/c/m/p/q
高危患儿	4	e/f/g/h/p/q	挺腹步态	1	c/d/p/q/r
立位平衡障碍	3	b/c/i/n/o/p/q/r	骨盆带分离障碍	1	a/r/k
直跪行障碍	3	a/b/c/d/p/q/	前庭功能障碍	1	l/n/o/p/q
膝关节内外翻障碍	3	n/p/q

基于ICF-CY平衡姿态悬吊治疗方案的设计

Development of a nature posture treatment suspension therapy based on ICF-CY

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组别	n	满意	接受	不良事件
对照组	53	53	53	0
观察组	51	50	49	1
χ²值		5.459	2.119	1.049
P值		0.065	0.145	0.306

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