Increasing physical function through physiatric intervention for children with paediatric neurotransmitter disorders.
Increasing physical function through physiatric intervention for children with paediatric neurotransmitter disorders.
复制标题
通过对患有小儿神经递质疾病的儿童进行物理干预来增强身体功能。
DOI：
10.1007/s10545-009-1190-0
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发表时间：
2009
影响因子：
4.2
通讯作者：
Morozova,O
中科院分区：
文献类型：
--
作者：
Evans,S;Forester,K;Pettiford,JM;Morozova,O
大多数患有小儿神经递质疾病的儿童继发于中枢神经系统损伤而具有整体功能缺陷。儿科理疗师与多学科团队合作，通过使肌肉张力正常化和改善身体姿势来帮助改善身体功能。痉挛、僵硬和肌张力障碍的组成部分可能都需要在综合治疗方案中加以考虑。张力紊乱的并发症包括皮肤破裂、疼痛、睡眠障碍和吞咽困难。通过使用药物和设备以及实施治疗和治疗性运动的综合方法，理疗师可以帮助患有这组疾病的儿童最大限度地实现功能独立。药物治疗包括GABA-激动剂，包括巴氯芬和苯二氮卓类、α-2肾上腺素能激动剂、左旋多巴和多巴胺能药物以及丹曲林。鞘内巴氯芬可用于这些药物难治性患者。此外，医生可能会使用肉毒杆菌毒素，苯酚，或手术干预，如选择性背根切断术或肌腱延长。药物治疗必须与适当的适应性设备结合使用，以最大限度地提高治疗效果。关注功能，试图提高独立性，旨在提高儿童的生活质量。我们提出了一个框架和理由的儿科神经递质疾病的功能后果的管理。
Most children with paediatric neurotransmitter diseases have global functional deficits secondary to central nervous system damage. Paediatric physiatrists, working in conjunction with a multi-disciplinary team, help to improve physical function by normalizing muscle tone and improving body position. Components of spasticity, rigidity, and dystonia may all need to be considered in a comprehensive treatment programme. Complications of disordered tone include skin breakdown, pain, sleep disturbance, and dysphagia. With an integrated approach to use of medications and equipment as well as implementation of therapy and therapeutic exercise, physiatrists can help maximize functional independence for children with this group of disorders. Pharmacological treatment includes GABA-agonists including baclofen and benzodiazepines, alpha-2 adrenergic agonists,l-dopa and dopaminergic agents, and dantrolene. Intrathecal baclofen may be used in patients refractory to these medications. In addition, physicians may utilize botulinum toxin, phenol, or surgical interventions such as selective dorsal rhizotomy or tendon lengthening. Pharmacological treatment must be used in conjunction with appropriate adaptive equipment in order to maximize therapeutic benefit. Focus on function in an attempt to increase independence is targeted to improve the child′s quality of life. We present a framework and rationale to the management of the functional consequences of the paediatric neurotransmitter diseases.