| Objective:Cerebral Palsy(CP)is a life-long deformity disease that seriously endangers children’s health,causing great pressure on society and families.Among them,spastic cerebral palsy is the most common clinically,accounting for about 80%,often complicated by serious complications such as musculoskeletal deformation and hip dislocation.Because the heavier the spasm of children with cerebral palsy,the more severe the degree of hip joint lesions.The current clinical practice is mainly to monitor hip joint development,without effective targeted intervention measures.In order to improve the problem of hip joint development disorder in children with spastic cerebral palsy,the research group intends to use a strict randomized controlled study(Clinical registration number: Chi CTR2000040948)to explore the impact of continuous passive motion(CPM)of the hip joint on gross motor function and hip joint development of children with spastic cerebral palsy,with a view to improving the recovery of children with cerebral palsy.Methods:Using the method of prospective case-control study,65 children with spastic cerebral palsy diagnosed with hip dysplasia in June 2020 ～ December 2021 at the Pediatric Neurorehabilitation Center of the First Affiliated Hospital of Anhui Medical University were selected.All subjects were randomly divided into CPM treatment group and conventional treatment group,including 45 cases in the CPM treatment group and20 cases in the conventional treatment group.On the basis of routine goal-directed exercise rehabilitation training,the CPM treatment group was treated with the hip CPM instrument(that is,the external fixator was connected to the power device to make the hip joint continue passive motion)for 40-60 minutes,twice a day,five times a week,for two consecutive months;The conventional treatment group was merely treated with goal-directed exercise rehabilitation training.At the time of enrollment and 2 months after treatment,the children in the two groups were evaluated for gross motor function(GMFM88 items),bilateral plain hip radiographs(hip joint displacement percentage MP value,acetabular index AI value)and Harris hip function score,and the differences in gross motor function and hip structure and function development between the two groups were compared.The Chi-square test was used to analyze the baseline data of the count data,and the statistical analysis between the two groups and before and after treatment was carried out by the methods of two independent sample t-test and paired-sample t-test,respectively.Results:1 Gross motor function: before treatment,the total percentage of GMFM in the CPM instrument treatment group(46.95 ± 22.11)and the total percentage of GMFM in the conventional treatment group(36.17 ± 25.94)had no difference(P>0.05),but after2 months of treatment,the total percentage of GMFM in the CPM instrument treatment group(58.79 ± 20.92)was better than the conventional treatment group(42.49 ± 27.22),the difference was statistically significant(P < 0.05).2 Hip joint structure: MP value and AI value of CPM instrument treatment group and conventional treatment group after 2 months of treatment [CPM instrument group:left MP(27.32 ± 2.54)right MP(27.70 ± 2.16);left AI(28.01 ± 3.92)right AI(27.51 ±3.80)] [Routine group: left MP(29.55 ± 3.41)right MP(29.92 ± 2.98);left AI(30.11 ±3.54)right AI(29.76 ± 3.64)] was significantly lower than before treatment [CPM group:left MP(31.69 ± 2.30)right MP(31.91 ± 2.47);left AI(32.26 ± 4.24)right AI(32.16 ±4.12)],[Routine group: left MP(30.42 ± 3.13)right MP(30.75 ± 3.02);left AI(30.83 ±3.54)right AI(30.37 ± 3.60)],Comparison between the two groups before treatment was no difference,but Two months after treatment,the difference between the two groups and within the group was statistically significant(P < 0.05,P < 0.001).3 Hip joint function: Before treatment,Harris hip joint function score(57.60 ±12.20)in CPM instrument treatment group and Harris hip function score(53.90 ± 15.29)in conventional treatment group had no significant difference(P > 0.05),but after 2months of treatment,Harris hip function score(76.67 ± 9.25)in CPM treatment group was higher than Harris hip function score(58.80 ± 15.90)in conventional treatment group,with significant difference(P < 0.05).4 Adverse reactions: Of the total 65 subjects,3 had transient lower limb paralysis,which improved after full rest.No other adverse reactions.Conclusions:The CPM treatment group and the conventional treatment group improved the gross motor function and the structure and improve the development of hip joint after treatment,and there was a statistical difference between the two groups.In other words,the hip CPM instrument can improve the gross motor function and the structure and function,and has a certain protective effect on improving gross motor function,hip joint structure and function in children with spastic cerebral palsy,which is worthy of clinical promotion. |
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