Effect of whole body vibration training on fine motor ability of children with cerebral palsy with the assistance of digital OT system

doi:10.11852/zgetbjzz2022-1142

Abstract

Abstract: Objective To explore the effect of whole body vibration training on the fine motor function of children with spastic hemiplegia, so as to provide clinical reference for occupational therapy of hemiplegic cerebral palsy. Methods A total of 68 children with spastic hemiplegia in Shengjing Hospital were enrolled in this study from October 2020 to October 2022, and were randomly divided into control group (n=34) and study group (n=34).Both groups were given conventional occupational therapy, while the study group was additionally provided with whole body vibration (WBV) training.Scores in fine motor function measurement-D (FMFM-D) (upper limb operation) and FMFM-E (hand-eye coordination) of FMFM before training, 4 weeks, 8 weeks and 12 weeks after training and the results of the Motion Control Report in the digital OT assessment system were compared between the two groups. Results Repeated-measures analysis of variance showed that FMFM-D score changed over time (F_time=76.017, P＜0.001), while grouping effect and interaction effect were not significant(F_group_/interaction=1.173, 0.470, P＞0.05).The change of FMFM-E score was influenced by both the time effect and group effect (F_time_{/group/interaction}=783.275, 4.209, 50.233, P＜0.05).After 8 and 12 weeks of training, the study group scored higher in FMFM-E than the control group(F=9.375,9.207, P＜0.05).The coincidence degree of motion trajectory was affected by both time effect and group effect (F_time_{/group/interaction}=567.166, 4.720, 47.497, P＜0.05).After 4, 8 and 12 weeks of training, the movement performance of the study group was better than that of the control group(F=8.783, 7.583, 8.937, P＜0.05).Movement speed was affected by both time effect and group effect (F_time_{/group/interaction}=351.375, 16.538, 73.909, P＜0.05).After 8 weeks and 12 weeks of training, the movement speed of the study group was higher than that of the control group (F=69.764, 60.557, P＜0.05). Conclusion Whole-body vibration training can improve the fine motor function, movement speed and hand-eye coordination of children with spastic hemiplegia.

Key words: cerebral palsy, fine motor function, whole body vibration, digital OT assessment and training system

摘要： 目的探究全身振动训练对痉挛型偏瘫患儿精细运动功能的影响效果,为偏瘫型脑瘫的作业治疗提供临床参考依据。方法选取2020年10月—2022年10月在中国医科大学附属盛京医院康复科进行训练的痉挛型偏瘫患儿68例,随机分成对照组(n=34)和观察组(n=34),两组均给予常规作业治疗,观察组在此基础上增加全身振动训练,比较其训练前、训练第4周、8周、12周的精细运动功能评估(FMFM)中D区(上肢操作)、E区(手眼协调)得分及数字OT评估系统中的《运动控制报告》结果。结果重复测量方差分析显示,D区分值随时间变化而改变(F_时间＝76.017,P_时间＜0.001),分组效应及交互效应无意义(F_组间_/交互＝1.173、0.470,P＞0.05);E区分值的改变受时间效应及分组效应的双重影响影响(F_时间_{/组间/交互}=783.275、4.209、50.233,P＜0.05),在训练8周及12周后,观察组的得分高于对照组(F＝9.375、9.207,P＜0.05);运动轨迹的重合度受时间效应及分组效应双重影响(F_时间_{/组间/交互}=567.166、4.720、47.497,P＜0.05),在训练第4周、8周及12周后,观察组的成绩优于对照组(F＝8.783、7.583、8.937,P＜0.05);运动速度受时间效应和组间效应双重影响(F_时间_{/组间/交互}=351.375、16.538、73.909,P＜0.05),在训练8周及12周后,观察组的运动速度优于对照组(F＝69.764、60.557,P＜0.05)。结论全身振动训练能够改善痉挛型偏瘫患儿的精细运动功能,提高患儿的运动速度及手眼协调能力。

关键词: 脑性瘫痪, 精细运动功能, 全身振动训练, 数字OT评估与训练系统

CLC Number:

R742.3

WANG Man, XIAO Yingying, ZHANG Yuanyuan, ZHANG Lixin. Effect of whole body vibration training on fine motor ability of children with cerebral palsy with the assistance of digital OT system[J]. Chinese Journal of Child Health Care, 2023, 31(5): 491-496.

王曼, 肖莹莹, 张园园, 张立新. 数字OT系统辅助下分析全身振动训练对脑瘫患儿精细运动能力影响的临床研究[J]. 中国儿童保健杂志, 2023, 31(5): 491-496.

References

[1] 徐开寿,肖农.康复治疗师临床工作指南-儿童疾患物理治疗技术[M].北京:人民卫生出版社,2019:30.
Xu KS,Xiao N.Clinical work guidelines for rehabilitation therapists-physiotherapy techniques for childhood disorders[M].Beijing:People's Medical Publishing House,2019:30.(in Chinese)
[2] 李林,武丽杰.人体发育学[M].北京:人民卫生出版社,2018:64.
Li L,Wu LJ.Human development science[M].Beijing:People's Medical Publishing House,2018:64.(in Chinese)
[3] 赵永秀,涂美,代明星,等.数字OT评估与治疗系统对脑卒中患者认知功能及日常生活活动能力影响[J].社区医学杂志,2019,17(24):1565-1571.
Zhao YX,Tu M,Dai MX,et al.Effect of digital OT assessment and treatment of system on cognitive function and activities of daily living in stroke patienst[J].J Community Med,2019,17(24):1565-1571.(in Chinese)
[4] 贠国俊,梁显荣,王景刚,等.全身振动训练对痉挛型偏瘫患儿运动功能影响的临床研究[J].中国儿童保健杂志,2020,28(7):823-826.
Yun GJ,Liang XR,Wang JG,et al.Clinical study on the effect of whole body vibration training on motor function in children with spastic hemiplegia[J].Chin J Child Health Care,2020,28(7):823-826.(in Chinese)
[5] 严善钟,金娟,陈世动,等.全身振动训练对痉挛型脑瘫患儿20例步行速度及粗大运动功能影响研究[J].中国实用儿科杂志,2021,36(1):33-37.
Yan SZ,Jin J,Chen SD,et al.Effect of whole body vibration on gait speed and gross motor function of pediatric patients with spastic cerebral palsy:A study of 20 cases[J].Chin J Pract Pediatr,2021,36(1):33-37.(in Chinese)
[6] 李岩,何雯雯,董燕飞,等.全身振动训练对脑卒中偏瘫患者本体感觉及平衡功能的影响[J].中国康复医学杂志,2021,36(6):709-712.
Li Y,He WW,Dong YF,et al.Effects of whole-body vibration training on proprioception and balance function in patients with hemiplegia after stroke[J].Chin J Rehabil Med,2021,36(6):709-712.(in Chinese)
[7] 李洪波,周谋望.全身振动训练对亚急性期脑卒中患者上肢运动功能的影响[J].中国康复医学杂志,2020,35(9):1055-1060.
Li HB,Zhou MW.Effects of whole body vibration training on upper limb motor function in hemiplegic patients with subacute stroke[J].Chin J Rehabil Med,2020,35(9):1055-1060.(in Chinese)
[8] 王月丽,曾明,姚云海,等.振动结合上肢任务导向性训练对脑卒中后偏瘫患者上肢运动功能的影响[J].中国康复医学杂志,2018,33(4):447-450.
Wang YL,Zeng M,Yao YH,et al.Effects of vibration combined with upper limb task-oriented training on upper limb motor function in patients with hemiplegia after stroke[J].Chin J Rehabil Med,2018,33(4):447-450.(in Chinese)
[9] Adaikina A,Hofman PL,Gusso S.The effect of side-alternating vibration therapy on mobility and health outcomes in young children with mild to moderate cerebral palsy: Design and rationale for the randomized controlled study[J].BMC Pediatr,2020,20(1):508.
[10] 中国康复医学会儿童康复专业委员会,中国残疾人康复协会小儿脑性瘫痪康复专业委员会,中国医师协会康复医师分会儿童康复专业委员会,等.中国脑性瘫痪康复指南(2022)第一章:概论[J].中华实用儿科临床杂志,2022,37(12):887-892.
Chinese Association of Rehabilitation Medicine Pediatric Rehabilitation Committee,Chinese Association of Rehabilitation of Disabled Persons Rehabilitation Committee for Cerebral Palsy,Chinese Medical Doctor Association Pediatric Rehabilitation Committee,et al.Chinese rehabilitation guidelines for cerebral palsy(2022)part 1:Overview[J].Chin J Appl Clin Pediatr, 2022,37(12):887-892.(in Chinese)
[11] Song S,Lee K,Jung S,et al.Effect of horizontal whole-body vibration training on trunk and lower-extremity muscle tone and activation,balance,and gait in a child with cerebral palsy[J].Am J Case Rep,2018,19:1292-1300.
[12] Tekin F,Kavlak E.Short and long-term effects of whole-body vibration on spasticity and motor performance in children with hemiparetic cerebral palsy[J].Percept Mot Skills,2021,128(3):1107-1129.
[13] Ritzmann R,Stark C,Krause A.Vibration therapy in patients with cerebral palsy: A systematic review[J].Neuropsychiatr Dis Treat,2018, 14:1607-1625.
[14] Ruhde L,Hulla R.An overview of the effects of whole-body vibration on individuals with cerebral palsy[J].J Pediatr Rehabil Med,2022,15(1):193-210.
[15] 李晓捷.实用小儿脑性瘫痪康复治疗技术[M].北京:人民卫生出版社,2017:5.
Li XJ.Practical rehabilitation techniques for children with cerebral palsy[M].Beijing: People's Medical Publishing House,2017:5.(in Chinese)
[16] 窦祖林.作业治疗学[M].北京:人民卫生出版社,2018:138.
Dou ZL.Occupational therapy[M].Beijing:People's Medical Publishing House,2018:138.(in Chinese)
[17] Martakis K,Stark C,Rehberg M,et al.Reference centiles to monitor the 6-minute-walk test in ambulant children with cerebral palsy and identification of effects after rehabilitation utilizing whole-body vibration[J].Dev Neurorehabil,2021,24(1):45-55.
[18] Jung Y,Chung EJ,Chun HL,et al.Effects of whole-body vibration combined with action observation on gross motor function,balance,and gait in children with spastic cerebral palsy: A preliminary study[J].J Exerc Rehabil,2020,16(3):249-257.
[19] Pin TW,Butler PB,Purves S,et al.Feasibility of whole body vibration therapy in individuals with dystonic or spastic dystonic cerebral palsy: A pilot study[J].J Rehabil Med Clin Commun,2019,2:1000021.
[20] Lopes S,Magalhães P,Pereira A,et al.Games used with serious purposes: A systematic review of interventions in patients with cerebral palsy[J].Front Psychol,2018,9:1712.
[21] 朱如乔,莫昊凤,姜积华,等.数字OT训练系统对痉挛型偏瘫脑瘫儿童精细运动功能的疗效观察[J].中国康复2020,35(9):480-483.
Zhu RQ,Mo HF,Jiang JH,et al.Therapeutic effect of digital OT trainingsystem on the fine motor function of children with spastic cerebral palsy[J].Chin J Rehabil,2020,35(9):480-483.(in Chinese)
[22] 中国康复医学会儿童康复专业委员会,中国残疾人康复协会小儿脑性瘫痪康复专业委员会,中国医师协会康复医师分会儿童康复专业委员会,等.中国脑性瘫痪康复指南(2022)第四章:康复治疗(下)[J].中华实用儿科临床杂志, 2022,37(17):1281-1309.
Chinese Association of Rehabilitation Medicine Pediatric Rehabilitation Committee,Chinese Association of Rehabilitation of Disabled Persons Rehabilitation Committee for Cerebral Palsy, Chinese Medical Doctor Association Pediatric Rehabilitation Committee,et al.Chinese rehabilitation guidelines for cerebral palsy(2022)part 4:Rehabilitation treatment(Ⅱ)[J].Chin J Appl Clin Pediatr,2022, 37(17):1281-1309.(in Chinese)