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首页> 外文期刊>Journal of rehabilitation medicine : >Rameckers, E.A.A.a b c d , Duysens, J.d e , Speth, L.A.W.M.a b , Vles, H.J.S.b , Smits-Engelsman, B.c d e Effect of addition of botulinum toxin-a to standardized therapy for dynamic manual skills measured with kinematic aiming tasks in children with spastic hemiplegia
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Rameckers, E.A.A.a b c d , Duysens, J.d e , Speth, L.A.W.M.a b , Vles, H.J.S.b , Smits-Engelsman, B.c d e Effect of addition of botulinum toxin-a to standardized therapy for dynamic manual skills measured with kinematic aiming tasks in children with spastic hemiplegia

机译：Rameckers，E.A.a. a b c d，Duysens，J. d e，Speth，L.A.W.M. a b，Vles，H.J.S. b，Smits-Engelsman，B.c d e在运动学上针对运动障碍的儿童通过针对运动学目的性体能任务测量的动态手动技能，将肉毒杆菌毒素-a添加到标准化的动态手法治疗中的效果

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Objective: To measure the effect of intensive therapy and the lasting effect of a standardized functional training programme with vs. without the addition of chemodernervation of the muscles of the forearm and hand. Patients and methods: Twenty children with spastic hemiplegia, aged 4-16 years, were matched for baseline characteristics and randomized to standardized task-oriented therapy for 6 months with or without botulinum toxin injections. Dynamic kinematic outcome measures were: speed, accuracy, end-point spread and performance. Measurements of active and passive range of motion, stretch-restricted angle of the elbow and wrist, Ashworth scores and Melbourne Assessment of Unilateral Upper Limb Function were made. All measures were performed at baseline, 2 weeks after injection of botulinum toxin and after 6 months (at the end of therapy), and 3 months after end of the therapy. Results: Clinical measures showed improvement in both groups. However, no significant differences emerged between groups on functional measures. Directly after the botulinum toxin injection all kinematic outcome measures showed a decrease, but baseline values were re-established during the therapy period. After botulinum toxin injections a temporarily significant greater increase in speed and performance was found. These results illustrate the need for further quantitative research into the effects of botulinum toxin.
机译：目的：通过不使用前臂和手部肌肉的化学神经支配治疗，评估强化治疗的效果和标准功能训练计划的持久效果。患者和方法：将20例4-16岁的痉挛性偏瘫患儿的基线特征进行匹配，并随机接受6个月的有无肉毒杆菌毒素注射的标准化任务导向治疗。动态运动学指标包括：速度，准确性，终点扩散和性能。测量了主动和被动的运动范围，肘部和腕部的伸展限制角度，Ashworth评分和墨尔本单侧上肢功能评估。所有措施均在基线，注射肉毒杆菌毒素后2周和6个月后（在治疗结束时）以及治疗结束后3个月进行。结果：两组的临床指标均得到改善。但是，各组之间在功能指标上没有显着差异。肉毒杆菌毒素注射后，所有运动学结局指标均显示下降，但在治疗期间重新建立了基线值。注射肉毒杆菌毒素后，发现速度和性能暂时显着提高。这些结果说明需要进一步定量研究肉毒毒素的作用。

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