抑制痙攣支架鞋對痙攣型雙邊麻痺兒童粗動作功能之效果

在1982年7月到1988年4月，本研究共收集59例痙孿型雙邊麻痺兒童，以Semans計分系統評估他們在接受抑制痙攣支架鞋前、中、後3個期間的動作控制能力。本研究分2個階段進行，在第1階段中，12例患童接受2～6星期的抑制痙攣石膏鞋，結果顯示穿上石膏鞋配合神經發展治療，患童動作控制能力增加，但在石膏鞋拆除後，效果逐漸消失。因此，在第2階段中，將患童分為3組，第1組接受神經發展治療、石膏鞋與兩片式支架鞋；第2組接受神經發展治療與石膏鞋；第3組僅接受神經發展治療。結果顯示抑制痙攣支架鞋可增加動作控制能力，兩片式抑制痙攣支架鞋會延長石膏鞋的效果。但其長期效果及有關機轉則仍有待進一步研究。

關鍵字

無資料

並列摘要

The use of below knee inhibitory ankle-foot orthoses as an adjunctive treatment for cerebral-palsied children has been recommanded in several literatures recently, but little quantitative reports concerning the efficacy of these orthoses have been published. From July 1982 to April 1988, 59 children with spastic diplegia were included in this study. Seman's grading of basic motor control assessment (motor score) was conducted to evaluate the ability of postural control in 9 positions. This study was performed in 2 periods. From July 1982 to July 1983, to examine the effect of inhibitory casts, 12 spastic diplegics were included. Results showed that the functional motor control of the spastic diplegics improved during casting, but the therapeutic effect diminished after the cast-removal. To investigate whether 2 pieces inhibitory ankle-foot orthoses worn after casts removal can keep the effect longer, 47 spastic diplegics were included from April 1986 to April 1988. According to the treatment programs, they were devided into 3 groups. Group 1 received neurodevelopmental therapy (NDT) 10 weeks, plus 6-week inhibitory casts applied from the third week, and followed by 2 pieces inhibitory ankle-foot orthoses after casts removal. Group 2 had NDT plus 6-week inhibitory casts, and no orthoses were added after casts removal. Group 3 had NDT only. Comparison between the pre-treatment score and the post-treatment score was analyzed by paired t-test in each group. All the post-scores were significantly higher than the pre-scores. It indicated that NDT had improved movement control no matter with or without inhibitory orthoses. However, NDT plus inhibitory orthoses would improve movement control more than that without orthoses. Because the improvement score during the whole treatment period was higher in Group 1 (10.7±7.3) than Group 3 (2.9±2.0). During pre-casting period or on-casting period, the improvement scores in Group 1 and Group 2 were similar. After casts removal, the motor score of Group 1 kept increasing; that of Group 2 was deteriorated. The improvement score showed significant difference between Group 1 and Group 2 during post-casting period. From this study, it concluded that the 2 pieces inhibitory orthoses could keep the effect of inhibitory casts. Inhibitory orthoses with NDT is a better treatment for improving motor control of spastic diplegics than NDT only.

並列關鍵字

Inhibitory ankle-foot orthoses ； Cerebral palsy ； Gross motor

國際替代計量

抑制痙攣支架鞋對痙攣型雙邊麻痺兒童粗動作功能之效果

全文下載

主題瀏覽