摘要
目的评估功能性电刺激(FES)治疗脑瘫的有效性及长期疗效。方法检索PubMed、Embase、Web of Science、Cochrane Library、中国生物医学文献数据库(CBM)、CNKI、万方数据库、维普有关FES治疗脑瘫儿童的随机对照试验,检索时限从建库至2020年3月26日。至少2名评价员独立提取数据,采用Cochrane 5.1.0偏倚风险评估工具对纳入研究的质量进行评估,数据分析采用Review Manager 5.3软件。结果最终纳入11篇文献,共计513例患儿。FES组在粗大运动功能测试88项(GMFM-88) D、E区评分(MD=8.14, 95%CI 6.26~10.02, P <0.001)、GMFM-88 B区评分(MD=8.77, 95%CI 4.00~13.53, P <0.001)、改良Ashworth量表(MAS)评分(MD=-1.05, 95%CI-1.25~-0.84, P <0.001)、Kyphosis角(MD=-10.67, 95%CI-12.21~-9.13, P <0.001)、Cobb角(MD=-2.66, 95%CI-3.38~-1.93, P <0.001)、步长(MD=3.35, 95%CI1.81~4.90, P <0.001)、步速(MD=0.09, 95%CI 0.05~0.14, P <0.001)、随访6周时GMFM评分(MD=4.84,95%CI 1.90~7.77, P=0.001)等方面均明显优于对照组。随访6周时FES组与对照组的MAS评分无显著性差异(MD=0.04, 95%CI-0.30~0.37, P=0.84)。结论 FES能够改善脑瘫儿童下肢、躯干功能,但解除肌肉痉挛的长期疗效不显著。
Objective To evaluate the efficacy and long-term effect of functional electrical stimulation(FES)on cerebral palsy.Methods Literature retrieval was carried out in the electronic databases of PubMed,Embase,Web of Science,Cochrane Library,China Biology Medicine Disc(CBM),CNKI,Wanfang Database and VIP.The time limit was from the establishment of these databases to March 26th,2020.According to the inclusion and exclusion criteria,randomized controlled trials about FES for children with cerebral palsy were included.At least two evaluators extracted the data independently and used Cochrane 5.1.0 bias risk assessment tool to evaluate the quality of included studies.The data was analyzed with Review Manager 5.3 software.Results A total of eleven studies with 513 children were included.The Gross Motor Function Measure-88(GMFM-88)D/E scores(MD=8.14,95%CI 6.26 to 10.02,P<0.001),GMFM-88 B score(MD=8.77,95%CI 4.00 to 13.53,P<0.001),modified Ashworth Scale(MAS)score(MD=-1.05,95%CI-1.25 to-0.84,P<0.001),Kyphosis angle(MD=-10.67,95%CI-12.21 to-9.13,P<0.001),Cobb's angle(MD=-2.66,95%CI-3.38 to-1.93,P<0.001),step length(MD=3.35,95%CI 1.81 to 4.90,P<0.001),walking speed(MD=0.09,95%CI 0.05 to 0.14,P<0.001)and GMFM score at six weeks follow-up(MD=4.84,95%CI 1.90 to 7.77,P=0.001)were better in FES group than in the control group.There was no significant difference in MAS score between two groups after six weeks of follow-up(MD=0.04,95%CI-0.30 to 0.37,P=0.84).Conclusion FES could improve the lower-limb and trunk function of children with cerebral palsy,however,the longterm effect of relieving muscle spasm was not significant.
作者
汪乐
徐林
胡传宇
张厚君
徐杰
赵毅
任敬佩
曾杰
于睿钦
穆晓红
WANG Le;XU Lin;HU Chuan-yu;ZHANG Hou-jun;XU Jie;ZHAO Yi;REN Jing-pei;ZENG Jie;YU Rui-qin;MU Xiao-hong(Dongzhimen Hospital of Beijing University of Chinese Medicine,Beijing 100700,China)
出处
《中国康复理论与实践》
CSCD
北大核心
2021年第4期420-428,共9页
Chinese Journal of Rehabilitation Theory and Practice
关键词
脑性瘫痪
功能性电刺激
下肢功能
长期疗效
META分析
cerebral palsy
functional electrical stimulation
lower-limb function
long-term effect
meta-analysis
作者简介
汪乐(1993-),男,汉族,四川南充市人,硕士研究生,主要研究方向:脊柱外科、脑瘫外科。;通讯作者:穆晓红(1972-),女,汉族,河南郑州市人,博士,教授、主任医师,博士研究生导师,主要研究方向:脑性瘫痪、脊柱退行性病变,E-mail:mxh__2004@163.com。
