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目的为脑瘫患儿粗大运动功能障碍程度及康复疗效评估提供科学、简便的工具。方法采用GMAE、GDSGM分别对34例脑瘫患儿治疗前后粗大运动功能进行评估比较。对83例脑瘫患儿随机分组,分别在治疗前后评估,将得分输入GMAE进行数据分析。A组:治疗时间3个月,常规治疗加GMAE提供的预期训练目标;B组:治疗2个月,方案同A组;C组:仅常规治疗3个月。对照组为30例健康患儿,两次测评间隔3个月。结果 34例脑瘫患儿治疗前后评估,GMAE结果差异显著(t=5.26,P<0.0001);GDS-GM结果差异不显著(S=87.5,P>0.05)。83例患儿中,各组首次、二次检测及两次检测GMAE结果差值均低于对照组(P<0.05);A组两次检测结果差值明显高于B组和C组(P<0.05)。对照组中,3岁以上组GMAE首次测量值显著高于3岁以内组(P<0.05)。3岁以内组两次测量差值明显高于3岁以上儿童,差异显著(P<0.05)。结论 GMAE可量化脑瘫患儿粗大运动功能障碍程度及康复训练后进步变化幅度,具有科学、简便、实用的特点。其敏感性、特异性均优于GDS-GM。还能反映不同年龄粗大运动发育水平的特点,其显示的预期训练目标对脑瘫患儿个体精细化康复训练有一定的指导意义,适合国内临床广泛使用。
Objective To provide a scientific and convenient tool for assessing the degree of gross motor dysfunction and rehabilitation in children with cerebral palsy. Methods GMAE and GDSGM were used to evaluate the gross motor function of 34 children with cerebral palsy before and after treatment. 83 children with cerebral palsy were randomly divided into groups and evaluated before and after treatment. The scores were entered into GMAE for data analysis. Group A: The treatment time was 3 months. The conventional treatment plus the expected training goal provided by GMAE; Group B: treatment for 2 months, the same as Group A; Group C: only routine treatment for 3 months. Control group, 30 healthy children, two intervals between three months. Results The 34 children with cerebral palsy had significant differences in GMAE before and after treatment (t = 5.26, P <0.0001). There was no significant difference in GDS-GM between the two groups (S = 87.5, P> 0.05). In 83 children, the differences of the first, second and the second GMAE in each group were lower than those in the control group (P <0.05); the differences between the two groups in the A group were significantly higher than those in the B and C groups <0.05). In the control group, the first measurement of GMAE in patients over 3 years old was significantly higher than that of 3 years old (P <0.05). The difference between the two measurements within 3 years of age was significantly higher than that of children over 3 years of age (P <0.05). Conclusions GMAE can quantify the degree of gross motor dysfunction and the changes in the rate of change after rehabilitation training in children with cerebral palsy. It is scientific, simple and practical. Its sensitivity and specificity are better than GDS-GM. But also reflects the developmental characteristics of coarse motor at different ages. The expected training target indicated has certain guiding significance for the fine rehabilitation training of children with cerebral palsy and is suitable for the widespread use in clinical practice.