1. 上海交通大学医学院附属上海儿童医学中心中医科,上海,200127
2. 上海市残疾人康复职业培训中心,上海,200125
3. 上海中医药大学,上海,201203
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方茜, 徐纯鑫, 孙克兴, 等. “引带导气”推拿法对痉挛型脑瘫患儿步态运动学参数的影响[J]. 上海中医药杂志, 2020,54(3):63-66.
FANG Xi, XU Chunxin, SUN Kexing, et al. Effect of “Yindai Daoqi” tuina massage on gait kinematic parameters of children with spastic cerebral palsy[J]. Shanghai Journal of Traditional Chinese Medicine, 2020,54(3):63-66.
方茜, 徐纯鑫, 孙克兴, 等. “引带导气”推拿法对痉挛型脑瘫患儿步态运动学参数的影响[J]. 上海中医药杂志, 2020,54(3):63-66. DOI: 10.16305/j.1007-1334.2020.03.018.
FANG Xi, XU Chunxin, SUN Kexing, et al. Effect of “Yindai Daoqi” tuina massage on gait kinematic parameters of children with spastic cerebral palsy[J]. Shanghai Journal of Traditional Chinese Medicine, 2020,54(3):63-66. DOI: 10.16305/j.1007-1334.2020.03.018.
目的:探讨步行功能导向的“引带导气”推拿法对痉挛型脑瘫患儿步态运动学参数的影响。 方法:将36例痉挛型双瘫患儿分为治疗组和对照组,每组18例。治疗组采用以收引带脉与点、按、推大腿前侧阳明经手法推拿为主,并诱导足跟蹬离运动的“引带导气”训练法,对照组采用被动推拿手法结合步行平台训练。两组治疗时间均为每次40 min,每周5次,疗程3个月;观察粗大运动功能评估量表(GMFM)走、跑、跳(E能区)百分比及三维步态变化情况。 结果:①治疗前后组内比较,两组GMFM-88项走、跑、跳(E能区)积分差异有统计学意义(P<0.05);组间治疗后比较,GMFM-88项走、跑、跳(E能区)积分差异均有统计学意义(P<0.05)。②治疗前后组内比较,两组步态时空参数各个指标差异均有统计学意义(P<0.05);组间治疗后比较,步长、膝关节伸展(支撑相)、膝关节屈曲(摆动相)、髋关节外旋外展、腘角及伸膝时踝背屈等角度指标差异有统计学意义(P<0.05)。 结论:“引带导气”推拿法较被动推拿在改善痉挛型脑瘫患儿步行功能方面有一定的优势,可以更好地改善下肢关节力线,提高步行效率。
Objective:To evaluate the effect of “Yindai Daoqi” tuina massage on kinematics parameter in spastic children with cerebral palsy. MethodsA total of 36 children with spastic cerebral palsy were randomly divided into the experimental group and the control group with 18 cases each. The experimental group adopted the manipulation on the belt vessel and the Yangming channel on the lateral side of the thigh and received “Yindai Daoqi” tuina massage to induce the heel pedaling movement. The control group received the passive massage manipulation and kinesitherapy. The treatment time of both groups was 40 minutes each time, 5 times a week, and the course of treatment was 3 months. MAS, GMFM and 3DGA were assessed before and after treatment. Results:①Compared before and after treatment, both groups showed significant difference in the scores of GMFM-88 in walking, running and jumping (e-energy area) (P<0.05); after treatment, there was significant difference between two groups in the scores of GMFM-88 in walking, running and jumping (e-energy area) (P<0.05). ②Compared before and after treatment, both groups showed significant differences in gait kinematic parameters (P<0.05); after treatment, there were significant differences between two groups in the step length, knee extension (support phase), knee flexion (swing phase), hip external rotation and abduction, popliteal angle and ankle dorsiflexion during knee extension (P<0.05). Conclusion:“Yindai Daoqi” tuina massage has an advantage on the walking function improvement in children with spastic type cerebral palsy as it can facilitate the lower limb joint alignment and improve the walking efficiency.
脑瘫推拿引带导气三维步态分析
cerebral palsytuina massageYindai Daoqithree-dimensional gait analysis (3DGA)
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