腦性麻痺症之 物理治療服務概覽 嗚謝 新界西醫院聯網病人啟力基金 Supported by Patient Empowerment Programme, New Territories West Cluster 屯門醫院 物理治療部 (兒童組) 編 輯
Spastic (Athetoid) 1. 2. 3. (Ataxic) (Mixed) a. b. 4. 1. 2. 3. 4. 5. 1. 2. 3. 1 2
International Classification of Function - ICF ICF Health Condition Body functions and structure Activities Participation 1. Myofascial release Environmental Factors Personal Factors 3 4
2. Neuro-muscular electrical stimulation 3. 4. 5. 5 6
7 8
K 9 10
BOTOX 0 2 2 6 3 10 8 10 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 11 12
Botulinum Toxin 1 2 3 4 3 4 L2S2 13 14
2. 1. 15 16
(Crouching gait) (Jump knee gait) (Recurvatum gait) (Stiff knee gait) (Tip toe gait) (Scissor gait) 17 18
19 20
1. Ackman JD, Russman BS, Thomas SS, et al.: Comparing botulinum toxin A with casting for treatment of dynamic equinus in children with cerebral palsy. Developmental medicine and child neurology 2005; 47: 620-627. 2. Chan HS, Yam KY, Yiu B, et al.: Multidimensional Outcome Measures. Paediatric Neurology 2008; 39:22-32 3. David D. Limbrick J, Park TS: CEREBRAL PALSY, SPASTICITY,AND SELECTIVE DORSAL RHIZOTOMY. Pediatric Handbook: Congress of Neurological Surgeons, 2009. 5. Engsberg JR, Ross SA, Collins DR, Park TS: Effect of selective dorsal rhizotomy in the treatment of children with cerebral palsy. Journal of Neurosurgery 2006; 105(1 Suppl): 8-15. 6. Lundkvist A, Hägglund G: Orthopaedic surgery after selective dorsal rhizotomy. Journal of pediatric orthopaedics. Part B 2006; 15: 244-246. 7. Nordmark E, Josenby AL, Lagergren J, Andersson G, Strömblad LG, Westbom L: Long-term outcomes five years after selective dorsal rhizotomy. BMC Pediatrics 2008; 8: 54. 8. O'Neil ME, Fragala-Pinkham MA, Westcott SL, et al.: Physical therapy clinical management recommendations for children with cerebral palsy - spastic diplegia: achieving functional mobility outcomes. Pediatric physical therapy 2006; 18: 49-72. 9. Westbom L, Hagglund G, Lundkvist A, Nordmark E, Stromblad L-G: New treament methods for spasticity and dystonia in children with cerebral palsy dictate multidisciplinary teamwork. Comprehensive approach yields good results. Lakartidningen 2003; 100: 125-130. 10. (Botulinum Toxin) 11., 2008. 4. Desloovere K, Molenaers G, Jonkers I, et al.: A randomized study of combined botulinum toxin type A and casting in the ambulant child with cerebral palsy using objective outcome measures. European journal of neurology 2001; 8 Suppl 5: 75-87. 21 22