动作观察疗法对脑性瘫痪患儿上肢功能作用的系统综述

doi:10.3969/j.issn.1006-9771.2023.05.010

Abstract

Abstract:

Objective To systematically evaluate the effect of action observation therapy (AOT) on upper limb function in children with cerebral palsy.

Methods Relevant literatures about the effect of AOT on upper limb function in children with cerebral palsy were retrieved from the databases of PubMed, Embase, Cochrane Library, Web of Science and CNKI, from the establishment to July 9, 2022.

Results Eleven articles involving 497 patients were included, which were mainly published in the past ten years. The studies included hospital-based studies with therapist supervision and home-based studies without therapist supervision, mainly related to the improvement of upper limb function of AOT in children with cerebral palsy. Experimental group performed actions related to activities of daily living, while control group mainly watched video clips excluding actions, 15 to 120 minutes a time, three to five times a week, with most of the intervention periods of three to four weeks. AOT improved the upper limb function of children with cerebral palsy in terms of body structure and function, and activity and participation, specifically grip strength, muscle tension, and hand dexterity and function.

Conclusion Hospital-based AOT with therapist supervision can improve upper limb function in children with cerebral palsy, while the effect of home-based AOT without therapist supervision and the long-term effect of AOT need to be further studied.

Key words: cerebral palsy, action observation therapy, upper limb, systematic review

CLC Number:

R742.3

LAN Shiling, PANG Wei, LI Xin, LIU Mengyun, ZHAN Yujun. Effect of action observation therapy on upper limb function in cerebral palsy: a systematic review[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(5): 558-564.

Figures/Tables 3

纳入文献	研究类型	受试者类型	年龄 (E/C)	运动功能	n (E/C)	干预措施 (E/C)	干预时间	康复效果	评价指标
Buccino等^[10] (2018)	RCT	痉挛型偏瘫、痉挛型四肢瘫	5~11岁	MACS ≤ 4	11/7	RR+AOT/ RR+FOT	每天30 min，每周5 d，共3周	手功能改善	AHA； MUUL
Kirkpatrick等^[11](2016)	RCT	痉挛型偏瘫	5岁2个月/ 5岁4个月	手能主动抓握	35/35	AOT/FOT	每天15 min，每周5 d，共3个月	手功能未明显改善	AHA； MA2； ABILHAND-Kids
Quadrelli等^[12] (2019)	随机交叉实验	痉挛型	4~14岁	MACS ≤ 4	4/4	AOT+FOT/ FOT+AOT	每天18 min，每周3 d，共6周	上肢功能改善	AHA； MUUL
Simon-Martinez等^[13](2020)	RCT	痉挛型偏瘫	(9.6±1.1)岁/ (9.6±1.1)岁	HFCS ≥ 4； MACS ≤ 3	22/22	CIMT+AOT/ CIMT+FOT	每次1 h，共15次，在9 d内完成	手功能改善	AHA； MA2； JTHFT；握力； MAS; 9孔钉板测试
Buccino等^[14] (2012)	RCT	痉挛型偏瘫、痉挛型四肢瘫	7岁6个月/8岁	不清楚	8/7	AOT/FOT	每周3次，共3周	上肢运动功能改善	MUUL
Kim等^[15](2014)	RCT	痉挛型偏瘫、痉挛型双瘫、痉挛型四肢瘫	(9.1±2.4)岁/ (9.2±3.1)岁	上肢肌力不低于A+	8/8	AOT+RR/ RR+FOT	每天30 min，每周3 d，共4周	上肢功能改善	握力； MAS； BBT； ABILHAND-Kids； WeeFIM
Sgandurra等^[16](2013)	RCT	痉挛型偏瘫	(9.5±2.1)岁/(9.9±2.8)岁	HFCS:IV~VIII级	12/12	AOT/FOT	每天1 h，连续3周	上肢活动改善	AHA；MUUL； ABILHAND-Kids
Kim^[17](2020)	RCT	痉挛型偏瘫、痉挛型双瘫	(10.2±1.3)岁/ (9.4±1.3)岁	HFCS:IV~VIII级	5/5	AOT/AOT	每天30 min(C)/60 min(E)，每周3 d，共4周	握力和上肢功能改善	握力；QUEST；ABILHAND-Kids
魏亚敏等^[18](2018)	RCT	痉挛型偏瘫	(74.0±16.1)月/(80.7±15.9)月	GMFCS: I~II级；MACS ≤ 3	10/11	RR+AOT/ RR+FOT	每天20 min，每周5 d，共12周	上肢运动功能改善	握力； UEFT； WeeFIM
张晓东等^[19](2020)	RCT	痉挛型	(7.0±2.2)岁/(7.2±2.1)岁	MACS ≤ 3	46/45	RR+AOT/ RR	每天2 h，每周5 d，共1个月	上肢功能改善	UEFT； MAS
马樱等^[20](2020)	RCT	痉挛型	(5.0±0.8)岁/(5.0±0.9)岁	不清楚	90/90	RR+AOT/ RR+FOT	每天18 min，每周5 d，共12周	上肢精细运动功能改善	FMFM； MAS

References 36

[1]	GULATI S, SONDHI V. Cerebral palsy: an overview[J]. Indian J Pediatr, 2018, 85(11): 1006-1016. doi: 10.1007/s12098-017-2475-1 pmid: 29152685
[2]	中国康复医学会儿童康复专业委员会, 中国残疾人康复协会小儿脑性瘫痪康复专业委员会, 中国医师协会康复医师分会儿童康复专业委员会, 等. 中国脑性瘫痪康复指南(2022)第一章:概论[J]. 中华实用儿科临床杂志, 2022, 37(12): 887-892.
	Children's Rehabilitation Committee of Chinese Medical Association of Rehabilitation, Children's Cerebral Palsy Rehabilitation Committee of China Disabled Persons Rehabilitation Association, Children's Rehabilitation Committee of Rehabilitation Physicians Branch of Chinese Medical Doctor Association, et al. Chinese Guidelines for Rehabilitation of Cerebral Palsy (2022) Chapter 1: Introduction[J]. Chin J Appl Clin Pediatr, 2022, 37(12): 887-892.
[3]	SELLIER E, PLATT M J, ANDERSEN G L, et al. Decreasing prevalence in cerebral palsy: a multi‐site European population‐based study, 1980 to 2003[J]. Dev Med Child Neurol, 2016, 58(1): 85-92.
[4]	NOVAK I, MORGAN C, FAHEY M, et al. State of the evidence traffic lights 2019: systematic review of interventions for preventing and treating children with cerebral palsy[J]. Curr Neurol Neurosci Rep, 2020, 20(2): 1-21. doi: 10.1007/s11910-020-1021-0
[5]	李晓捷, 邱洪斌, 姜志梅, 等. 中国十二省市小儿脑性瘫痪流行病学特征[J]. 中华实用儿科临床杂志, 2018, 33(5): 378-383.
	LI X J, QIU H B, JIANG Z M, et al. Epidemiological characteristics of cerebral palsy in twelve provinces in China[J]. Chin J Appl Clin Pediatr, 2018, 33(5): 378-383.
[6]	BOXUM A G, LA BASTIDE-VAN GEMERT S, DIJKSTRA L J, et al. Development of the quality of reaching in infants with cerebral palsy: a kinematic study[J]. Dev Med Child Neurol, 2017, 59(11): 1164-1173. doi: 10.1111/dmcn.13538 pmid: 28877349
[7]	李弯月, 尚亚茹, 钱宝延, 等. 动作观察疗法治疗脑卒中后上肢功能障碍的Meta分析[J]. 中华物理医学与康复杂志, 2021, 43(9): 844-847.
	LI W Y, SHANG Y R, QIAN B Y, et al. Action observation therapy for upper limb dysfunction after stroke: a meta-analysis[J]. Chin J Phys Med Rehabil, 2021, 43(9): 844-847.
[8]	申嘉怡, 张通, 胡雪艳, 等. 动作观察疗法对脑卒中后单侧忽略的效果[J]. 中国康复理论与实践, 2018, 24(8): 930-937. doi: 10.3969/j.issn.1006-9771.2018.08.012
	SHEN J Y, ZHANG T, HU X Y, et al. Effect of action observation therapy on unilateral neglect after stroke[J]. Chin J Rehabil Theory Pract, 2018, 24(8): 930-937.
[9]	CASHIN A G, MCAULEY J H. Clinimetrics: Physiotherapy Evidence Database (PEDro) Scale[J]. J Physiother, 2020, 66(1): 59. doi: S1836-9553(19)30092-X pmid: 31521549
[10]	BUCCINO G, MOLINARO A, AMBROSI C, et al. Action observation treatment improves upper limb motor functions in children with cerebral palsy: a combined clinical and brain imaging study[J]. Neural Plast, 2018, 2018: 4843985.
[11]	KIRKPATRICK E, PEARSE J, JAMES P, et al. Effect of parent‐delivered action observation therapy on upper limb function in unilateral cerebral palsy: a randomized controlled trial[J]. Dev Med Child Neurol, 2016, 58(10): 1049-1056. doi: 10.1111/dmcn.13109
[12]	QUADRELLI E, ANZANI A, FERRI M, et al. Electrophysiological correlates of action observation treatment in children with cerebral palsy: a pilot study[J]. Dev Neurobiol, 2019, 79(11/12): 934-948. doi: 10.1002/dneu.v79.11-12
[13]	SIMON-MARTINEZ C, MAILLEUX L, HOSKENS J, et al. Randomized controlled trial combining constraint-induced movement therapy and action-observation training in unilateral cerebral palsy: clinical effects and influencing factors of treatment response[J]. Ther Adv Neurol Disord, 2020, 13: 1756286419898065.
[14]	BUCCINO G, ARISI D, GOUGH P, et al. Improving upper limb motor functions through action observation treatment: a pilot study in children with cerebral palsy[J]. Dev Med Child Neurol, 2012, 54(9): 822-828. doi: 10.1111/j.1469-8749.2012.04334.x pmid: 22765352
[15]	KIM J Y, KIM J M, KO E Y. The effect of the action observation physical training on the upper extremity function in children with cerebral palsy[J]. J Exerc Rehabil, 2014, 10(3): 176-183. doi: 10.12965/jer.140114
[16]	SGANDURRA G, FERRARI A, COSSU G, et al. Randomized trial of observation and execution of upper extremity actions versus action alone in children with unilateral cerebral palsy[J]. Neurorehabil Neural Repair, 2013, 27(9): 808-815. doi: 10.1177/1545968313497101 pmid: 23886886
[17]	KIM D H. Comparison of short- and long-time action observation training (AOT) on upper limb function in children with cerebral palsy[J]. Physiother Pract Res, 2020, 41(1): 53-58.
[18]	魏亚敏, 姜志梅, 汤敬华, 等. 动作观察疗法对痉挛型脑性瘫痪偏瘫患儿上肢功能的效果[J]. 中国康复理论与实践, 2018, 24(4): 432-436. doi: 10.3969/j.issn.1006-9771.2018.04.010
	WEI Y M, JIANG Z M, TANG J H, et al. Effect of action observation therapy on upper limb function of hemiplegic children with spastic cerebral palsy[J]. Chin J Rehabil Theory Pract, 2018, 24(4): 432-436.
[19]	张晓东, 江继茹, 王文霞, 等. 痉挛型脑瘫患儿基于体感游戏的动作观察训练康复模式研究[J]. 实用临床医药杂志, 2020, 24(22): 51-53.
	ZHANG X D, JIANG J R, WANG W X, et al. Rehabilitation model of action observation training based on somatosensory games in children with spastic cerebral palsy[J]. J Clin Med Pract, 2020, 24(22): 51-53.
[20]	马樱, 陈锦萍. 动作观察疗法对痉挛型脑瘫患儿上肢运动功能和肌张力的康复效果[J]. 中国乡村医药, 2020, 27(12): 13-14.
	MA Y, CHEN J P. Rehabilitation effect of action observation therapy on upper limb motor function and muscle tone in children with spastic cerebral palsy[J]. Chin J Rural Med Pharm, 2020, 27(12): 13-14.
[21]	GALLESE V, FADIGA L, FOGASSI L, et al. Action recognition in the premotor cortex[J]. Brain, 1996, 119(2): 593-609. doi: 10.1093/brain/119.2.593
[22]	FERRARI P F, ROZZI S, FOGASSI L. Mirror neurons responding to observation of actions made with tools in monkey ventral premotor cortex[J]. J Cogn Neurosci, 2005, 17(2): 212-226. doi: 10.1162/0898929053124910
[23]	KEYSERS C, PARACAMPO R, GAZZOLA V. What neuromodulation and lesion studies tell us about the function of the mirror neuron system and embodied cognition[J]. Curr Opin Psychol, 2018, 24: 35-40. doi: S2352-250X(18)30033-2 pmid: 29734039
[24]	ZHANG J J Q, FONG K N K, WELAGE N, et al. The activation of the mirror neuron system during action observation and action execution with mirror visual feedback in stroke: a systematic review[J]. Neural Plast, 2018, 2018: 2321045.
[25]	李新宇. 基于镜像神经元理论的动作观察疗法在神经康复中的应用进展[J]. 中国康复, 2016, 31(2): 153-155.
	LI X Y. Application of action observation therapy based on mirror neuron theory in neural rehabilitation[J]. Chin J Rehabil, 2016, 31(2): 153-155.
[26]	BUCCINO G. Action observation treatment: a novel tool in neurorehabilitation[J]. Philos Trans R Soc Lond B Biol Sci, 2014, 369(1644): 20130185. doi: 10.1098/rstb.2013.0185
[27]	IACOBONI M, MOLNAR-SZAKACS I, GALLESE V, et al. Grasping the intentions of others with one's own mirror neuron system[J]. PLoS Biol, 2005, 3(3): e79. doi: 10.1371/journal.pbio.0030079
[28]	SMALL S L, BUCCINO G, SOLODKIN A. The mirror neuron system and treatment of stroke[J]. Dev Psychobiol, 2012, 54(3): 293-310. doi: 10.1002/dev.20504 pmid: 22415917
[29]	KHALIL R, TINDLE R, BORAUD T, et al. Social decision making in autism: on the impact of mirror neurons, motor control, and imitative behaviors[J]. CNS Neurosci Ther, 2018, 24(8): 669-676. doi: 10.1111/cns.13001 pmid: 29963752
[30]	VOGT S, BUCCINO G, WOHLSCHLÄGER A M, et al. Prefrontal involvement in imitation learning of hand actions: effects of practice and expertise[J]. Neuroimage, 2007, 37(4): 1371-1383. doi: 10.1016/j.neuroimage.2007.07.005 pmid: 17698372
[31]	RYAN D, FULLEN B, RIO E, et al. Effect of action observation therapy in the rehabilitation of neurologic and musculoskeletal conditions: a systematic review[J]. Arch Rehabil Res Clin Transl, 2021, 3(1): 100106.
[32]	MAKKI D, DUODU J, NIXON M. Prevalence and pattern of upper limb involvement in cerebral palsy[J]. J Child Orthop, 2014, 8(3): 215-219. doi: 10.1007/s11832-014-0593-0 pmid: 24824566
[33]	OUYANG R G, YANG C N, QU Y L, et al. Effectiveness of hand-arm bimanual intensive training on upper extremity function in children with cerebral palsy: a systematic review[J]. Eur J Paediatr Neurol, 2020, 25: 17-28. doi: 10.1016/j.ejpn.2019.12.017
[34]	SGANDURRA G, CECCHI F, BEANI E, et al. Tele-UPCAT: study protocol of a randomised controlled trial of a home-based Tele-monitored upper limb children action observation training for participants with unilateral cerebral palsy[J]. BMJ Open, 2021, 8(5): e017819. doi: 10.1136/bmjopen-2017-017819
[35]	JUNG Y, CHUNG E J, CHUN H L, et al. Effects of whole-body vibration combined with action observation on gross motor function, balance, and gait in children with spastic cerebral palsy: a preliminary study[J]. J Exerc Rehabil, 2020, 16(3): 249-257. doi: 10.12965/jer.2040136.068 pmid: 32724782
[36]	MOLINARO A, MICHELETTI S, PAGANI F, et al. Action observation treatment in a tele-rehabilitation setting: a pilot study in children with cerebral palsy[J]. Disabil Rehabil, 2022, 44(7): 1107-1112. doi: 10.1080/09638288.2020.1793009

纳入文献	资格标准	随机分配	分配隐藏	基线相识	被试施盲	评估者施盲	被试流失率≤15%	意向性分析	组间统计比较	报告点测量和变异量值	总分
Buccino等^[10](2018)	√	√		√	√	√	√	√	√	√	8
Kirkpatrick等^[11](2016)	√	√	√	√	√		√	√	√	√	8
Quadrelli等^[12](2019)	√	√	√	√	√	√	√	√	√	√	9
Simon-Martinez等^[13](2020)	√	√		√		√	√	√	√	√	7
Buccino等^[14](2012)	√	√		√	√	√	√	√	√	√	8
Kim等^[15](2014)	√	√		√			√	√	√	√	6
Sgandurra等^[16](2013)	√	√	√	√		√	√	√	√	√	8
Kim^[17](2020)	√	√		√		√	√	√	√	√	7
魏亚敏等^[18](2018)	√	√		√			√	√	√	√	6
张晓东等^[19](2020)	√	√		√			√	√	√	√	6
马樱等^[20](2020)	√	√		√			√	√	√	√	6

Effect of action observation therapy on upper limb function in cerebral palsy: a systematic review

RichHTML

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

Figures/Tables 3

References 36

Related Articles 15

Metrics

Comments

Recommended 0

[1]	WANG Hangyu, GE Keke, FAN Yonghong, DU Lilu, ZOU Min, FENG Lei. Effect of active music therapy on cognitive function for older adults with cognitive impairment: a systematic review based on ICD-11 and ICF [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2024, 30(1): 36-43.
[2]	WEN Jianing, JIN Qiuyan, ZHANG Qi, LI Jie, SI Qi. Effect of cognitively engaging physical activity on developing executive function of children and adolescents: a systematic review based on ICF [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2024, 30(1): 44-53.
[3]	GE Keke, FAN Yonghong, WANG Hangyu, DU Lilu, LI Changjiang, ZOU Min. Health benefit of mindfulness intervention for older adults with insomnia disorders: a systematic review [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2024, 30(1): 54-60.
[4]	LIN Na, GAO Hanlu, LU Huiping, CHEN Yanqing, ZHENG Junfan, CHEN Shurong. Effect of virtual reality on upper limb function after stroke: a study of diffusion tensor imaging [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2024, 30(1): 61-67.
[5]	ZHANG Jingya, ZOU Min, SUN Hongwei, SUN Changlong, ZHU Juntong. Effect of psychological intervention on anxiety or depression in children and adolescents with hearing impairment: a systematic review [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(9): 1004-1011.
[6]	WANG Junyu, YANG Yong, YUAN Xun, XIE Ting, ZHUANG Jie. Effect of high-intensity interval training on executive function for healthy children and adolescents: a systematic review [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(9): 1012-1020.
[7]	WEI Xiaowei, YANG Jian, WEI Chunyan. Psychological and behavioral benefits of adapted yoga exercise for children with autism spectrum disorder in special education schools: a systematic review [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(9): 1021-1028.
[8]	YANG Yaru, YANG Jian. School-based physical activity-related health services and their health benefits within the World Health Organization health-promoting school framework: a systematic review of systematic reviews [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(9): 1040-1047.
[9]	WANG He, HAN Liang, KAN Mengfan, YU Shaohong. Efficacy of electrical stimulation on shoulder-hand syndrome after stroke: a systematic review and meta-analysis [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(9): 1048-1056.
[10]	SHI Jiawei, LI Lingyu, YANG Haojie, WANG Qinlu, ZOU Haiou. Effect of preoperative prerehabilitation training on total knee arthroplasty: a systematic review of systematic reviews [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(9): 1057-1064.
[11]	HU Xiaoshi, ZHANG Qi, YUE Qing, LIANG Yanhua, LI Xiaosong, FENG Amei, ZHANG Yanqing. Effect of orthopedic elastic bandages on gait symmetry and walking ability in children with spastic hemiplegic cerebral palsy [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(9): 1083-1089.
[12]	JIANG Changhao, HUANG Chen, GAO Xiaoyan, DAI Yuanfu, ZHAO Guoming. Effect of neurofeedback training on cognitive function in the elderly: a systematic review [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 903-909.
[13]	WEI Xiaowei, YANG Jian, WEI Chunyan, HE Qiling. Adapted physical education programs for psychomotor development in school settings for children with intellectual and developmental disabilities: a systematic review [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 910-918.
[14]	WANG Haiyun, WANG Yin, ZHOU Xinjie, HE Aiqun. Effect of transcranial direct current stimulation combined with acupuncture on central and upper limb function in stroke patients based on central-peripheral-central theory [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 919-925.
[15]	CHEN Yiting, WANG Qian, CUI Shenhong, LI Yingcai, ZHANG Siyu, WEI Yanxu, REN Hui, LENG Jun, CHEN Bin. Effect of bilateral sequential repetitive transcranial magnetic stimulation on motor function of upper limbs in stroke patients [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 926-932.