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目的:探讨指导家长参与强化训练对纠正痉挛型双瘫患儿尖足步态效果的作用。方法:将50例痉挛型双瘫患儿分为观察组(27例)和对照组(23例)。对照组只进行综合康复治疗,观察组在综合康复治疗的基础上实施家长参与的强化训练,3个月为1个疗程。治疗前后采用盲法评定法对患儿足背屈角被动活动范围、粗大运动功能量表(GMFM)的站立及行走功能项目进行评定。结果:(1)治疗前两组各项比较无差异(P>0.05)。(2)治疗3个月后,观察组足背屈角被动活动度较对照组降低(P<0.05);GMFM站立及行走功能评分均较对照组增高(P<0.05)。(3)两组治疗后足背屈角被动活动度、GMFM站立及行走功能评分均较治疗前改善(P<0.05)。结论:指导家长参与强化训练可更好地提高痉挛型双瘫患儿的纠正效果,是值得推广的康复治疗模式。
Objective: To explore the role of parents in strengthening training to correct gait effects in children with spastic diplegia. Methods: Fifty children with spastic diplegia were divided into observation group (n = 27) and control group (n = 23). The control group only carried out comprehensive rehabilitation treatment. The observation group carried out the intensive training involving the parents on the basis of the comprehensive rehabilitation treatment, and the 3 months was a course of treatment. Before and after treatment, the children’s dorsiflexion passive range of motion, standing and walking function of gross motor function scale (GMFM) were evaluated by blinded method. Results: (1) There was no significant difference between the two groups before treatment (P> 0.05). (2) After 3 months of treatment, the passive dorsiflexion angle of the observation group was lower than that of the control group (P <0.05). The score of GMFM standing and walking function was higher than that of the control group (P <0.05). (3) The passive dorsiflexion degree of the two groups after treatment was significantly improved (P <0.05). Conclusion: Guiding parents to participate in intensive training can improve the corrective effect of children with spastic diplegia. It is worth promoting the rehabilitation model.