Vol. 30-31/2021-2022 Nr 60
okładka czasopisma Child Neurology
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NEUROLOGIA DZIECIĘCA

Pismo Polskiego Towarzystwa Neurologów Dziecięcych

PL ISSN 1230-3690
e-ISSN 2451-1897
DOI 10.20966
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Trening siłowy kończyn górnych jako forma rehabilitacji dzieci i młodzieży z mózgowym porażeniem dziecięcym: systematyczny przegląd piśmiennictwa


Strength training of upper limbs as a form of rehabilitation in children and adolescents with cerebral palsy: a systematic literature review




*Klinika Kardiologii Wieku Dziecięcego i Pediatrii Ogólnej WUM, Szkoła Doktorska Warszawski Uniwersytet Medyczny
** Oddział Fizjoterapii, II Wydział Lekarski, Warszawski Uniwersytet Medyczny
*** Klinika Kardiologii Wieku Dziecięcego i Pediatrii Ogólnej, Warszawski Uniwersytet Medyczny

https://doi.org/10.20966/chn.2021-2022.60.478
Neurol Dziec 2021-2022; 31-32, 60: 26-39
Pełen tekst artykułu PDF Trening siłowy kończyn górnych jako forma rehabilitacji dzieci i młodzieży
z mózgowym por



STRESZCZENIE
Wstęp: Osłabienie siły mięśniowej jest jednym z kluczowych objawów ograniczających motorykę u pacjentów z mózgowym porażeniem dziecięcym (MPD). Przeprowadzony przegląd piśmiennictwa skupia się na efektach treningu siłowego (TS) kończyn górnych u dzieci z MPD. Materiał i Metody: Przegląd piśmiennictwa przeprowadzono zgodnie z wytycznymi PRISMA Statement. W celu weryfikacji skuteczności TS przeszukano wybrane medyczne bazy danych używając słów kluczowych: mózgowe porażenie dziecięce, trening siłowy, kończyna górna. Badania podzielono na dwie kategorie, te w których występuje sam trening siłowy oraz te, w których trening siłowy jest połączony z inną interwencją terapeutyczną. Wyniki: Znaleziono 19 publikacji, z których do końcowej analizy włączono 9 prac: 4 badania randomizowane, 1 badanie inne niż randomizowane i 4 analizy przypadku. Wyniki przedstawiono w formie tabelarycznej zgodnie z Międzynarodową Klasyfikacją Funkcjonowania, Niepełnosprawności i Zdrowia na poziomach: struktury i funkcji, aktywności oraz partycypacji. W analizowanych badaniach wykorzystywano: TS jako samodzielną interwencję, TS wraz z elektrostymulacją oraz TS w połączeniu z iniekcjami toksyny botulinowej. Wnioski: Na podstawie przeanalizowanych badań nie można określić precyzyjnych wytycznych TS kończyn górnych w grupie dzieci z MPD z powodu zbyt dużej różnorodności badań w zakresie typu treningu, jego intensywności i czasu trwania. Istnieje konieczność ustalenia charakterystyki pacjentów z MPD i protokołu treningowego, które pozwolą na osiągnięcie maksymalnych korzyści płynących z tego rodzaju treningu na płaszczyźnie aktywności i partycypacji w życiu codziennym.

Słowa kluczowe: porażenie dziecięce; trening siłowy; kończyna górna


ABSTRACT
Introduction. Muscle strength weakness is the main symptom limiting motor skills in patients with cerebral palsy (CP). This literature review focuses on the effects of upper limb strength training (ST) in children with CP. Materials and methods. The literature review was conducted in accordance with PRISMA Statement guidelines. To verify the effectiveness of ST, medical databases were screened using keywords: cerebral palsy, strength training, resistance training, upper limb, upper extremity. Studies were divided into two categories involving strength training alone and strength training in combination with another therapeutic intervention. Results. Nineteen publications were found, 9 of which were included in the final analysis: 4 randomised studies, 1 non-randomised study and 4 case studies. The results are presented in tabular form according to the International Classification of Functioning, Disability and Health at the activity and participation levels. The analyzed studies used: ST as a stand-alone intervention, ST along with electrostimulation and ST in combination with botulinum toxin injections. Conclusions. Based on the reviewed studies it is not possible to define precise upper limb ST guidelines in a group of children with CP due to heterogeneity in the studies regarding: training type, intensity and duration. There is a need to establish the specific characteristics of patients with CP and the training protocol. This would maximize the benefits of this type of training at the level of activity and participation in daily life of the International Classification of Functioning, Disability and Health.

Key words: cerebral palsy, strength training, resistance training, upper limb, upper extremity


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