MOTOmed虚拟情景训练联合全身振动训练对痉挛型脑性瘫痪患儿下肢功能与步态平衡的影响

Effect of MOTOmed virtual scenario training combined with whole-body vibration training on lower limb function and gait balance in children with spastic cerebral palsy

摘要

目的 分析MOTOmed虚拟情景训练联合全身振动训练对痉挛型脑性瘫痪(SCP)患儿下肢功能与步态平衡的影响,为SCP患儿的康复治疗提供依据。方法 选取2023年12月—2024年12月于郑州大学附属儿童医院康复医学科就诊的72例SCP患儿为研究对象,采用随机数字表法分为对照组和观察组,每组各36例。在接受基础康复训练(包括运动疗法、作业疗法、电子生物反馈疗法、中医推拿及蜡疗等)的基础上,对照组给予MOTOmed虚拟情景训练;观察组给予MOTOmed虚拟情景训练联合全身振动训练。干预12周后,比较两组患儿下肢腓肠肌肌张力、被动背屈踝关节腓肠肌与主动跖屈踝关节腓肠肌肌电信号的均方根值(RMS)、粗大运动功能评定量表88项(GMFM-88)测评中D区(站立)、E区(行走跑跳)评分、重心移动轨迹面积、10m步行测试(10mWT)时间、足底压力偏差,评估联合干预对患儿下肢功能与步态平衡的改善效果。结果 干预前,两组各项指标差异均无统计学意义(P>0.05)。干预后,观察组下肢腓肠肌肌张力评分(Z=-2.861)、被动背屈踝关节腓肠肌RMS(t=-2.395)、主动跖屈踝关节腓肠肌RMS(t=-2.058)、重心移动轨迹面积(t=-2.029)、10mWT(t=-2.538)、足底压力偏差(t=-2.094)均显著低于对照组(P＜0.05);观察组D区(t=2.052)、E区(t=2.059)功能评分均显著高于对照组(P＜0.05)。结论 MOTOmed虚拟情景训练联合全身振动训练能够有效改善SCP患儿的下肢肌张力,提升站立和行走跑跳功能,优化动态平衡性与步态稳定性。

Abstract

Objective To investigate the synergistic effects of whole-body vibration training combined with MOTOmed virtual scenario training on lower limb function and gait balance in children with spastic cerebral palsy (SCP), so as to provide an evidence-based reference for the rehabilitation treatment of children with SCP. Methods A total of 72 children diagnosed with SCP were recruited from the Department of Rehabilitation Medicine, Children's Hospital Affiliated to Zhengzhou University between December 2023 and December 2024. Participants were randomly assigned into a control group and an observation group using a random number table, with 36 cases in each group. Both groups received conventional rehabilitation training. The control group additionally received MOTOmed-assisted virtual scenario training, while the observation group received MOTOmed-assisted virtual scenario training combined with whole-body vibration training. The intervention lasted for 12 weeks.After 12 weeks of intervention, indicators including lower limb gastrocnemius muscle tone, root mean square (RMS) values of the gastrocnemius during passive ankle dorsiflexion and active ankle plantarflexion, Gross Motor Function Measure 88(GMFM-88) scores for dimension D (standing) and dimension E (walking, running, and jumping), center of pressure (CoP) sway area, 10-meter walk test (10mWT) time, and plantar pressure deviation were compared between the two groups to evaluate the efficacy of the combined intervention on improving lower limb function and gait balance. Results Before the intervention, there were no significant differences in any outcome between the two groups (P>0.05). After the intervention, the gastrocnemius muscle tone score of the lower limbs was significantly lower in the observation group than in the control group (Z=-2.861,P＜0.05). Furthermore, the observation group demonstrated significantly lower RMS values for passive ankle dorsiflexion (t=-2.395) and active ankle plantarflexion (t=-2.058), center of gravity sway area (t=-2.029), 10mWT time (t=-2.538), and plantar pressure deviation (t=-2.094) compared to the control group (P<0.05). Functional assessment indicated a significantly higher GMFM dimension D(t=2.052) and E(t=2.059) score in the observation group compared to the control group (P<0.05). Conclusion Whole-body vibration training combined with conventional rehabilitation and MOTOmed-assisted virtual scenario training may further reduce lower-limb muscle tone, improve walking/running/jumping function, and optimizes dynamic balance and gait stability in children with SCP.

关键词

痉挛型脑性瘫痪 / 全身振动训练 / MOTOmed虚拟情景训练 / 下肢功能 / 步态平衡

Key words

spastic cerebral palsy / whole-body vibration training / MOTOmed virtual scenario training / lower limb function / gait balance

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基金资助

河南省医学科技攻关计划联合共建项目(LHGJ20240590);河南省医学科技攻关计划联合共建项目 (LHGJ20220752);郑州市医疗卫生领域科技创新指导计划项目(2025YLZDJH043)