生物反饋療法治療顱腦損傷患兒肢體功能障礙的臨床隨機對照研究

【摘要】 目的 探討生物反饋療法治療顱腦損傷患兒肢體功能障礙的效果。方法 前瞻性選取2022年8月—2024年7月河北省兒童醫(yī)院收治的62例顱腦損傷伴肢體功能障礙患兒，按1∶1比例隨機分為對照組、觀察組各31例。對照組采用綜合康復療法，觀察組采用生物反饋療法聯合綜合康復療法。比較兩組臨床療效、88項粗大運動評分量表（GFMF-88）、上肢運動功能評定量表（FMA-UE）、徒手肌力評定（MMT）、改良Ashworth肌張力評定量表（MAS）、兒童功能獨立性評定量表（WeeFIM）、下肢活動度。結果 觀察組臨床療效有效率93.55%與對照組77.42%比較差異無統計學意義（Pgt;0.05）；治療1、2個療程后觀察組GFMF-88量表D區(qū)、E區(qū)評分均高于對照組（Plt;0.05）；治療1、2個療程后觀察組FMA-UE評分高于對照組（Plt;0.05）；治療1、2個療程后觀察組MMT、WeeFIM評分高于對照組（Plt;0.05），MAS評分與對照組比較差異無統計學意義（Pgt;0.05）；治療1、2個療程后觀察組股角、腘角高于對照組，足背屈角低于對照組（Plt;0.05）。結論 生物反饋療法聯合綜合康復療法能有效改善顱腦損傷患兒肢體功能，降低肌張力，促進肌力恢復，提高自理能力。

【關鍵詞】 生物反饋；綜合康復；顱腦損傷；肢體功能；肌力；肌張力

【中圖分類號】 R493" 【文獻標志碼】 A" 【文章編號】 1672-7770（2025）01-0006-08

A clinical randomized controlled study on the treatment of limb dysfunction in children with traumatic brain injury using biofeedback therapy

Abstract： Objective To explore the effectiveness of biofeedback therapy in treating limb dysfunction in children with traumatic brain injury. Methods Sixty-two pediatric patients with traumatic brain injury accompanied by limb dysfunction were prospectively selected from August 2022 to July 2024 in Hebei Children’s Hospital. They were divided into a control group（31 cases） and an observation group（31 cases） using a computer-generated randomization method at a 1∶1 ratio. The control group received comprehensive rehabilitation therapy， while the observation group received biofeedback therapy combined with comprehensive rehabilitation therapy. The clinical efficacy， 88-item gross motor function measure（GFMF-88）， Fugl-Meyer assessment of upper extremity（FMA-UE）， manual muscle testing（MMT）， modified Ashworth muscle tone assessment scale（MAS）， Wee function independent measurement（Wee-FIM） and lower limb mobility were compared between the two groups. Results The clinical efficacy rate of the observation group was 93.55%， which was not significantly different from the control group’s 77.42%（Pgt;0.05）. After 1 or 2 courses of treatment， the scores of D and E areas of GFMF-88 scale in the observation group were higher than those in the control group（Plt;0.05）. After 1 or 2 courses of treatment， the FMA-UE score in the observation group was higher than that in the control group（Plt;0.05）. After 1 or 2 courses of treatment， the MMT and WeeFIM scores in the observation group were higher than those" in the control group（Plt;0.05）， while there was no significant difference in MAS scores between the"two groups（Pgt;0.05）. After 1 or 2 courses of treatment， the femoral angle and popliteal angle in the observation group were higher than those in the control group， while the dorsiflexion angle of the foot was lower than that in the control group（Plt;0.05）." Conclusions Biofeedback therapy combined with comprehensive rehabilitation can effectively improve the limb function of children with traumatic brain injury， reduce muscle tension， promote muscle strength recovery， and improve self-care ability.

Key words： biofeedback; comprehensive rehabilitation; traumatic brain injury; limb function; muscle strength; muscle tone

顱腦損傷是兒科常見急危重癥之一，通常由暴力直接或間接作用于頭部所導致，是導致兒童死亡和殘疾的重要原因［1］。隨著醫(yī)療技術的進步，此類患兒存活率明顯提高，但常遺留有不同程度的肢體功能障礙，嚴重影響患兒的生活及生長發(fā)育，給家庭和社會帶來沉重的負擔［2］。因此，盡早對顱腦損傷患兒進行康復治療，最大限度地恢復其受損功能顯得尤為重要。……