| Background: Cerebral Palsy(CP)is a kind of central nervous dysfunction syndrome characterized by postural and motor dysfunction.Spastic cerebral palsy is the most common form of child cerebral palsy,and its clinical manifestation is abnormal posture due to muscle spasm,and significant increase in muscle tension.As a refractory disease with higher disability rate,child cerebral palsy is bringing serious economic burden to a lot of families and the society.At present,there is no specific drug or therapeutic scheme for cerebral palsy in the world.Although some methods in modern rehabilitation medicine,such as exercise therapy,low-frequency pulsed electrical stimulation and hydrotherapy,can improve the motor function and abnormal posture of the children with cerebral palsy,but the effect is not significant.In recent years,traditional medicine has shown its unique advantages in the treatment of cerebral palsy with the continuous development of traditional Chinese medicine,and the traditional medicine combined with modern rehabilitation therapy has become a research spot in rehabilitation medicine.Modern rehabilitation hydrotherapy can significantly improve the lower limb muscle tension of children with spastic cerebral palsy,traditional herb bath for relaxing tendons and activating collaterals also shows obvious curative effect in improving the muscle tension and motor function of children with spastic cerebral palsy,and these methods have been widely used in clinical practice.Nevertheless,there are few reports on the treatment of children with spastic cerebral palsy by Chinese herb bath type hydrotherapy.In order to provide an effective method for the rehabilitation of children with spastic cerebral palsy,it is worth studying and discussing.Objective: to observe the therapeutic effect of Chinese herbal bath type hydrotherapy on relieving lower limb spasm in children with cerebral palsy,and provide a reliabletherapeutic scheme for the treatment of lower limb spasm in the children with cerebral palsy.Methods: the children with spastic cerebral palsy admitted to the Department of Children Rehabilitation of our hospital from April,2016 to June,2018 were collected,with the general information of all children recorded,including age,sex,height and weight and other objective clinical indicators.The lower limb spasm of these children was evaluated before and after treatment by using the Gross Motor Function Measure(GMFM),Modified Asthworth Scale(MAS)and motion range of ankle joint.By means of statistical analysis software,the statistical analysis of relevant basic data was conducted to evaluate whether it was comparable.The relevant studies were reviewed by the ethics committee,and the informed consents were signed by the families of these children.The included children were divided into groups A,B and C according to the randomized and controlled study method: Group A was the Chinese herb bath hydrotherapy group,Group B was the hydrotherapy group,and group C was the Chinese herb bath group.Group A was treated with Chinese herb bath hydrotherapy + routine rehabilitation;Group B was treated with hydrotherapy + routine rehabilitation;Group C was treated with Chinese herbal bath +routine rehabilitation.After three courses of treatment,the recovery of lower limb spasm was evaluated by relevant assessment measures,and the clinical efficacy of different treatment methods was compared.Results: a total of 57 children were included through statistical analysis,including 21 patients in the Chinese herb bath hydrotherapy group,19 patients in the hydrotherapy group and 17 patients in the Chinese herb bath group.The children included showed no statistical significance in the objective clinical indicators,such as age,sex and etc.,but comparable;the lower limb function scores of all children before grouping treatment showed no significant statistical difference,of which the D-region GMFM score in the Chinese herb bath hydrotherapy group was 24.3±3.2,24.4±3.5 in the hydrotherapy group,and 24.0±3.3 in the Chinese herb bath group before treatment,and it was 33.4±3.2,27.5±2.2 and 27.9±2.8 respectively after three courses of treatment,showing the D-region GMFM score was improved to some extent;meanwhile,the improvement in the Chinese herb bath hydrotherapy group was better than that in the other two groups.The E-region GMFM score in the Chinese herb bath hydrotherapy group was 28.2±9.9,27.6±8.5 in the hydrotherapy group,and 28.0±10.3 in the Chinese herb bath group before treatment,while 39.8±10.6,29.5±9.1,and 30.1±9.4 respectively after treatment.Therefore,the E-region GMFM scores in the three groups after treatment were improved,and the improvement in the Chinese herb bath hydrotherapy group was better than that in the other two groups.The modified Ashworth(MAS)Measure score was2.2±1.0 in the Chinese herb bath hydrotherapy group,2.3±0.8 in the hydrotherapy group,and 2.2±0.7 in the Chinese herb bath before treatment.The MAS Measure scores of the three groups after treatment were improved,and the improvement in the Chinese herb bath hydrotherapy group was better than that in the other two groups.The passive ankle flexion angle was 90.7°±3.2° in the Chinese herb bath hydrotherapy group,90.3°±3.5° in the hydrotherapy group,and 90.4°±3.6° in the Chinese herb bath group before treatment,and75.1°±4.7°,86.4°±4.2°,and 85.1°±4.3° respectively in the three groups after three courses of treatment.The foot dorsiflexion angle measured by passive ankle movement in the three groups was decreased after treatment,and the improvement in the Chinese herb bath type hydrotherapy group was better than that in the other two groups.Conclusions: Chinese herbal bath type hydrotherapy showed obvious clinical effect on relieving the gross motor function,adductor muscle tension and motion range of ankle joint in the children with spastic cerebral palsy,and it could be used as an effective therapy method to relieve lower limb spasm of children with cerebral palsy. |
