计算机辅助康复系统与常规康复对全面发育迟缓患儿运动功能改善效果的比较研究
Comparative Study on the Effects of the Computer Assisted Rehabilitation Environment System and Conventional Rehabilitation on Improving Motor Function in Children with Global Developmental Delay
张晓珍 1杨成波 1靳乾辉 2王帅 3周继和3
作者信息
- 1. 641418 四川省成都市，成都体育学院运动训练学院
- 2. 105122 俄罗斯莫斯科，俄罗斯体育大学适应性体育理论与方法系
- 3. 641419 四川省成都市，成都体育学院运动医学与健康学院
- 折叠
摘要
背景 全面发育迟缓（GDD）患儿常存在步行能力受限和平衡控制不足等运动功能障碍。常规康复在改善步行能力和平衡控制方面仍存在一定局限，亟须探索更有效的干预方式。目的 比较计算机辅助康复（CAREN）干预与常规干预对GDD患儿运动功能的改善效果，为优化其康复方案提供依据。方法 选取2025年7—11月在四川省八一康复中心接受康复训练的GDD患儿30例，采用随机数字表法分为CAREN组（15例）和常规组（15例）。常规组接受直线步行、走格子与节律步行、平衡垫站立与重心转移、跨越障碍与功能性步行进行常规干预。CAREN组采用气球动物园、2D迷宫、指挥交通、踩脚印进行CAREN干预。两组患儿60 min/次，1次/d，6d/周，连续干预12周。采用步行能力和平衡能力相关指标评估运动功能的改善效果，其中步行能力指标包括粗大运动功能量表-88（GMFM-88）D、E区评分、6分钟步行距离（6MWD）和步态时空参数，平衡能力指标包括静态平衡姿势稳定性（PS）（4种姿势：睁眼双脚并立、闭眼双脚并立、睁眼前后脚站立、睁眼单脚站立）和动态平衡稳定时间（TS）（4个方向：前进恢复时间、后退恢复时间、左侧恢复时间和右侧恢复时间）。结果 干预前，两组患儿GMFM-88 D、E 区评分、6MWD、步态时空参数及平衡能力指标比较，差异均无统计学意义（P>0.05）。干预后，与常规组相比，CAREN组患儿GMFM-88 D、E区评分更高，6MWD更长，步长和步速增加更显著，支撑期百分比下降及摆动期百分比上升更显著，睁眼双脚并立、睁眼前后脚站立、睁眼单脚站立姿势下PS值更低，4个方向TS恢复时间更短（P<0.05）。两组患儿干预前后各指标比较，差异均有统计学意义（P<0.05）。结论 与常规干预相比，CAREN干预对GDD患儿运动功能的改善效果更显著，本研究为CAREN系统应用于GDD患儿康复提供了初步支持证据。
Abstract
Background Children with global developmental delay (GDD) often present with motor dysfunction, including impaired walking ability and insufficient balance control. Conventional rehabilitation has limitations in improving walking ability and balance control; therefore, more effective interventions need to be explored. Objective To compare the effects of Computer Assisted Rehabilitation Environment (CAREN) intervention and conventional intervention on motor function in children with GDD, and to provide evidence for optimizing rehabilitation programs. Methods Thirty children with GDD who received rehabilitation training at the Bayi Rehabilitation Center of Sichuan Province from July to November 2025 were enrolled. They were randomly assigned, using a random number table, to the CAREN group (n=15) and the conventional group (n=15). The conventional group received conventional intervention, including straight-line walking, grid walking and rhythmic walking, standing on a balance pad with weight shifting, obstacle crossing, and functional walking. The CAREN group received CAREN intervention, including Balloon Zoo, 2D Maze, Traffic Command, and Footstep Tracking. Both groups received 60 min of training per session, once daily, 6 days per week, for 12 consecutive weeks. Motor function was evaluated using indicators of walking and balance performance. Walking performance indicators included the Gross Motor Function Measure-88 (GMFM-88) dimensions D and E scores, 6-minute walk distance (6MWD), and spatiotemporal gait parameters. Balance performance indicators included static postural stability (PS) under four postures, namely eyes-open bipedal standing, eyes-closed bipedal standing, eyes-open tandem standing, and eyes open single-leg standing, and dynamic balance assessed using time to stability (TS) in four directions, namely forward, backward, leftward, and rightward recovery times. Results Before intervention, there were no significant differences between the two groups in GMFM-88 dimensions D and E scores, 6MWD, spatiotemporal gait parameters, or balance performance indicators (P>0.05). After intervention, compared with the conventional group, the CAREN group showed higher GMFM-88 dimensions D and E scores, longer 6MWD, greater increases in step length and gait speed, a greater decrease in the percentage of stance phase and a greater increase in the percentage of swing phase, lower PS values under eyes-open bipedal standing, eyes-open tandem standing, and eyes-open single-leg standing, and shorter TS recovery times in all four directions (P<0.05). Significant differences were observed in all indicators before and after intervention in both groups (P<0.05). Conclusion Compared with conventional intervention, CAREN intervention may be more effective in improving motor function in children with GDD. This study provides preliminary evidence supporting the application of the CAREN system in the rehabilitation of children with GDD.关键词
发育障碍/全面发育迟缓/计算机辅助康复/儿童/运动功能/虚拟现实/步态/平衡引用本文复制引用
张晓珍,杨成波,靳乾辉,王帅,周继和.计算机辅助康复系统与常规康复对全面发育迟缓患儿运动功能改善效果的比较研究[EB/OL].(2026-05-21)[2026-05-22].https://chinaxiv.org/abs/202605.00142.学科分类
临床医学/医学研究方法
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