目的 比较单任务平板训练与双任务平板训练对痉挛型双瘫脑瘫儿童运动功能的影响。 方法 选取具备独立行走能力的痉挛型双瘫脑瘫患儿50例，按照随机数字表法将其分为单任务训练组(对照组)和双任务训练组(观察组)，每组25例，治疗期间分别脱落2例和3例，最终纳入对照组23例，观察组22例。2组患儿在常规康复训练基础上，对照组进行单任务平板训练，观察组进行双任务平板训练。治疗前、治疗2个月后(治疗后)，采用粗大运动功能评定量表(GMFM-88)D功能区(站立)和E功能区(走跑跳)、儿童平衡量表(PBS)、1 min步行试验(1MWT)评价2组患儿的粗大运动功能、平衡功能和步行移动能力，采用改良起立-行走计时(mTUG)测试、双任务mTUG测试、双任务成本(DTE)评估2组患儿在双任务条件下的表现。 结果 治疗前，2组患儿GMFM-88 D区和E区、PBS、1MWT、单任务mTUG、双任务mTUG、DTE比较，差异无统计学意义(P>0.05)。治疗后，2组患儿上述指标均较组内治疗前改善(P<0.05)。2组患儿治疗后GMFM-88 D区和E区、PBS、1MWT评估结果比较，差异无统计学意义(P>0.05)。观察组患儿治疗后双任务mTUG[(16.95±3.44)s]和DTE[(－18.79±12.25)%]改善程度优于对照组，差异有统计学意义(P<0.05)。 结论 在常规康复训练基础上进行单任务平板训练或双任务平板训练，均能改善痉挛型双瘫脑瘫患儿的运动功能，其中以双任务平板训练的疗效更优。 Objective To explore any effect of the single- and dual-task treadmill training on the functioning of children with bilateral spastic cerebral palsy. Methods Fifty children with bilateral spastic cerebral palsy were randomly divided into a single-task treadmill training group (the control group, n=25) and a dual-task treadmill training group (the observation group, n=25). All of the children also received routine rehabilitation training, and the control and observation groups also conducted single- and dual-task treadmill training in addition to the routine rehabilitation training, respectively. Before and after 2 months of treatment, each child′s gross motor functioning was quantified using sections D (standing) and E (walking, running and jumping) of the Gross Motor Function Measurement-88 (GMFM-88) instrument. Balance was quantified using the Pediatric Balance Scale (PBS) and walking mobility was quantified using a 1 minute walking test (1MWT). Modified and dual task Timed Up and Go (mTUG) tests and dual-task effects (DTE) tests were also administered. Results There were no significant differences in average test scores between the two groups before the treatment. After the treatment significant improvement was observed in both groups. There was no significant difference between the two groups in terms of average GMFM-88, PBS and 1MWT scores, but significantly greater improvement was observed in the average dual-task mTUG and DTE results of the observation group. Conclusion Both single- and dual-task treadmill training are effective supplements to routine rehabilitation training for children with bilateral spastic cerebral palsy. Dual-task treadmill training is more effective than the single-task version.
Dual-task treadmill training improves the motor functioning of children with bilateral spastic cerebral palsy
Objective To explore any effect of the single- and dual-task treadmill training on the functioning of children with bilateral spastic cerebral palsy. Methods Fifty children with bilateral spastic cerebral palsy were randomly divided into a single-task treadmill training group (the control group, n=25) and a dual-task treadmill training group (the observation group, n=25). All of the children also received routine rehabilitation training, and the control and observation groups also conducted single- and dual-task treadmill training in addition to the routine rehabilitation training, respectively. Before and after 2 months of treatment, each child′s gross motor functioning was quantified using sections D (standing) and E (walking, running and jumping) of the Gross Motor Function Measurement-88 (GMFM-88) instrument. Balance was quantified using the Pediatric Balance Scale (PBS) and walking mobility was quantified using a 1 minute walking test (1MWT). Modified and dual task Timed Up and Go (mTUG) tests and dual-task effects (DTE) tests were also administered. Results There were no significant differences in average test scores between the two groups before the treatment. After the treatment significant improvement was observed in both groups. There was no significant difference between the two groups in terms of average GMFM-88, PBS and 1MWT scores, but significantly greater improvement was observed in the average dual-task mTUG and DTE results of the observation group. Conclusion Both single- and dual-task treadmill training are effective supplements to routine rehabilitation training for children with bilateral spastic cerebral palsy. Dual-task treadmill training is more effective than the single-task version.
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