OBJECTIVE: The aim of this study was to investigate the effect of treadmill training in addition to routine physical therapy after BoNT-A injection in ambulatory children with spastic bilateral CP on lower extremity muscle strength, selective motor control, and mobility.
METHODS: A total of 30 spastic bilateral children with CP classified level II-III by the Gross Motor Function Classification System were randomly assigned the study and control groups. Both groups continued routine physical therapy treatments after multilevel BoNT-A injection into lower extremities, while the study group additionally underwent 8 weeks of treadmill training (20 min, two sessions per week). Handheld dynamometer, selective control assessment of lower extremity, temporospatial evaluation of gait, and Pediatric Evaluation of Disability Inventory were assessed before and after 8 weeks.
RESULTS: In both groups, hip, knee, and ankle muscle strength increased at the end of 8 weeks (p < 0.05); however, in the study group, hip flexor/extensor muscle strength (p < 0.05, ES ≥ 0.50), selective motor control of ankle (p < 0.01, ES = 1.17), walking speed (p < 0.01, ES = 2.60), step lengths (p < 0.01, ES = 1.32), and mobility (p < 0.01, ES = 1.37) increased significantly compared to those of the control group.
CONCLUSIONS: Treadmill training in addition to routine physical therapy after BoNT-A injection is beneficial for hip muscle strength, ankle selective motor control, walking quality, and functional mobility in the short term.
BACKGROUND: ClinicalTrials.gov identifier: NCT03580174.
目的:这项研究的目的是研究在BoNT-A注射后,除常规物理治疗外,跑步机训练对痉挛双侧CP卧床患儿下肢肌力的影响,选择性电机控制,和流动性。
方法:将根据粗大运动功能分类系统分为II-III级的30名痉挛型双侧CP患儿随机分为研究组和对照组。两组均在下肢多水平注射BoNT-A后继续常规物理治疗,而研究组额外接受了8周的跑步机训练(20分钟,每周两次会议)。手持式测力计,下肢选择性控制评估,步态的时空评估,在8周之前和之后评估儿童残疾评估量表。
结果:在两组中,臀部,膝盖,8周结束时,踝关节肌力增加(p<0.05);然而,在研究小组中,髋屈/伸肌肌力(p<0.05,ES≥0.50),踝关节选择性运动控制(p<0.01,ES=1.17),步行速度(p<0.01,ES=2.60),步长(p<0.01,ES=1.32),与对照组相比,迁移率(p<0.01,ES=1.37)显着增加。
结论:在BoNT-A注射后,除了常规的物理治疗,跑步机训练对髋部肌肉力量有益,踝关节选择性运动控制,步行质量,以及短期内的功能流动性。
背景:ClinicalTrials.gov标识符:NCT03580174。