作业疗法合并或不合并针刺对痉挛型偏瘫脑瘫患儿上肢疼痛及手功能的干预研究：一个三臂随机安慰剂对照临床试验(英文)

作者：赵非一; 徐燕; 岳立萍; 陈思涵; 夏小芥; 韩茨; 付强强

来源：World Journal of Acupuncture-Moxibustion, 2021, 1-17.

• Occupational therapy
• Acupuncture
• Placebo-acupuncture
• Pain
• Hand functions
• Spastic hemiplegic cerebral palsy Occupational therapy
• Spastic hemiplegic cerebral palsy

Objective:This study is conducted to investigate the effects of occupational therapy （OT） with or without combined acupuncture for upper limbpain and hand functions among children with spastic hemiplegic cerebral palsy. Methods:A total of 90patients who met the inclusion criteria were enrolled in a three-arm randomized， placebo-controlledtrial， and wereallocated to mono-occupational therapy （OT） group （patients= 30）， OT combined withreal-acupuncture（ORA） group （patients= 30）， and OT combined with placebo-acupuncture （OPA） group （patients= 30）， respectively. In addition to receiving the conventional OT program as the basic treatment for total8 weeks， patients in ORA and OPA group also received corresponding acupuncturetreatment 5 days per week for the first two weeks， 3 days per week for the next two weeks， 2 days per week for another two weeks， and 1 day per week for the last two weeks. Non-communicating children’s pain checklist-revised scale （NCCPC-R） was used for assessing the upper limbpain among patients.Squeeze dynamometry， modified Ashworth scale （MAS）， manual muscle testing （MMT）， Jebsen-Taylor hand function test （JTHFT） and box and block test （BBT） wereused for assessing various aspects of upper limb andhand functions among patients. Meanwhile， adverse effects were monitored and recorded. Results: After 8-week treatment，NCCPC-R global scores witnessed a dramatic decline in ORA group （P <0.05）， but not in either OPA （P>0.05） or OT group （P>0.05）. Dramatic increases were identified in both squeeze dynamometry scores and MMT scoresin all three groups （allP<0.05）. Furthermore， theincreasesof ORA group were more significant than those of another two groups （both P<0.05）. There were no significant changes in MAS global scores in each group （allP>0.05）. The BBT globalscores of all three groups significantly increased （all P<0.05） after treatment.Among them， the increase of the ORA group was muchhigher than that of the other two groups （P<0.05）. The 8-week treatment also had a significant impact on several sub-tests of JTFHT in each group.Nosignificantadverse event was reported. Conclusion:ORA is a potential and promising alternative therapy for mitigating upper limbpain and improving both upper limb andhand functions among children with spastic hemiplegic cerebral palsy.

• 单位
  华东师范大学; 上海杉达学院; 上海中医药大学; 上海市杨浦区中心医院