基于前庭的干预对痉挛型脑瘫儿童运动和姿势稳定性的影响：一项单盲随机对照试验
Impact of vestibular-based intervention on movement and postural stability in children with spastic cerebral palsy: a single-blind randomized controlled trial.
文献信息
| PMID | 42799642 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Sapna Dhiman |
| 作者单位 | School of Physiotherapy, Delhi Pharmaceutical Sciences and Research University, New Delhi, India. |
| 期刊 | Developmental neurorehabilitation |
| SCI 分区 | Q3 |
| IF | 1.6 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
背景与目的： 脑性瘫痪（CP）不仅与神经肌肉损伤相关，还与感觉加工改变有关，这是由于白质病变导致丘脑皮质投射中断所致。本研究旨在评估常规治疗（CT）和前庭刺激治疗（VST）对痉挛型CP儿童运动与身体位置加工、平衡及粗大运动功能的有效性。
方法： 在德里药物科学与研究大学（DPSRU）儿科物理治疗门诊部（OPD）开展了一项随机、双臂平行组临床试验。招募了6-12岁、粗大运动功能分类系统（GMFCS）III级的痉挛型双瘫CP儿童，然后将其等量随机分为接受CT的对照组和在接受CT基础上额外接受VST的试验组，VST持续30分钟，包括10分钟感觉准备和20分钟秋千活动，同时分别进行20分钟CT训练。干预前后，所有儿童均进行粗大运动功能测量-88（GMFM-88）、儿科平衡量表（PBS）以及儿童感觉特征量表-2（CSP-2）的运动加工和身体位置加工评估。在正态性检验（Kolmogorov-Smirnov检验）后，使用适当的参数检验分析数据，显著性水平设定为p<.05。
结果： 共招募80名GMFCS III级的痉挛型双瘫CP儿童。平均年龄为8.44±1.98岁。干预后，试验组在GMFM-88所有领域（p<.001）、身体位置加工（-43.01±5.56 vs. -27.50±2.59）、运动加工领域（-19.00±5.85 vs. -3.38±2.81）和PBS（9.00±2.66 vs. 2.08±1.16）方面均观察到统计学显著改善。
讨论： CP儿童由于本体感觉和前庭加工受损而存在平衡和姿势问题。本研究发现，在痉挛型双瘫CP儿童（GMFCS III级）中，VST联合CT可增强感觉加工、平衡和粗大运动表现。未来研究应探讨其对GMFCS I级和II级CP儿童步态特征的影响。
英文摘要
BACKGROUND AND OBJECTIVE: Cerebral Palsy (CP) is not only associated with neuromuscular impairments, but also with sensory processing alterations, due to disrupted thalamocortical projections caused by white matter lesions. This study aimed to evaluate the effectiveness of Conventional Therapy (CT) and Vestibular Stimulation Therapy (VST) on movement and body position processing, balance, and gross motor function in children with spastic CP.
METHODS: A randomized, two-arm parallel-group clinical trial was conducted in the Pediatric Physiotherapy Outpatient Department (OPD) of Delhi Pharmaceutical Sciences and Research University (DPSRU). Children with spastic diplegic CP, Gross Motor Function Classification System (GMFCS) level III, aged 6-12, were recruited for the study and then randomized equally to a control group that received CT and an experimental group that received VST in addition to CT for a duration of 30 min, with 10 min of sensory preparation and 20 min of activities on the swing, along with a 20-min CT session respectively. Before and after intervention, all children performed a Gross Motor Function Measure-88 (GMFM-88), the Pediatric Balance Scale (PBS), and the Movement Processing and Body Position Processing of Child Sensory Profile-2 (CSP-2). Data were analyzed using appropriate parametric tests after a normality check (Kolmogorov-Smirnov test), with the significance level set at p < .05.
RESULTS: A total of 80 children with spastic diplegic CP with GMFCS level III were recruited in the study. An average age of 8.44 ± 1.98 years was observed. Statistically significant improvements were observed in all domains of GMFM-88 (p < .001) post-intervention, in Body Position processing (-43.01 ± 5.56 vs. -27.50 ± 2.59), Movement processing domains (-19.00 ± 5.85 vs. -3.38 ± 2.81), and PBS (9.00 ± 2.66 vs. 2.08 ± 1.16) in the experimental group.
DISCUSSION: Children with CP have balance and postural problems due to impaired proprioceptive and vestibular processing. This study discovered that in children with spastic diplegic CP (GMFCS level III), VST in conjunction with CT enhances sensory processing, balance, and gross motor performance. Its impact on gait characteristics in children with CP at GMFCS levels I and II should be investigated in future research.