腦性麻痺是一種主要造成姿勢與動作控制障礙，進而影響動作功能及步行能力之症候群。獨立行走是腦性麻痺兒家屬最關切的一個問題，如何增進腦性麻痺兒童的步行能力，與增進其動作功能也是臨床上治療腦性麻痺兒童時一個值得研究與探討的問題。動作控制與動作學習理論，將任何一個動作視為一個完整的作業，並且認為動作的學習具有特定性，只有針對欲學習的動作本身作重複練習才能達到最佳效果；故步行能力的最佳訓練，即是針對步行本身做不斷地練習。由於跑步機可提供步行週期的重複練習；懸吊系統可以提供患者部分體重支持與平衡維持，將二者合併可協助尚無法獨立行走的患者做出類似平地行走之動作練習。本研究目的是依據動作控制與動作學習之理論，探討懸吊式跑步機之行走訓練，對痙攣型腦性麻痺兒童之動作功能與步行能力之效果。共有8位下肢痙攣型腦性麻痺兒童參與本實驗，實驗初期將受試者依據其診斷類型及粗動作功能分類等級，兩兩配對並以區間隨機分為兩組，分別為先接受基準治療(階段A)或懸吊式跑步機治療(階段B)之治療訓練，於第一階段結束後再交換治療方式。階段A時給予受試者不包含懸吊式跑步機訓練的一般治療活動；階段B時另外給予每週2-3次、每次至多20分鐘的懸吊式跑步機行走訓練，每階段為期12週。受試者於實驗開始、第一階段結束、第二階段結束共接受3次包括動作功能與步行能力的物理治療評估。實驗結果顯示痙攣型腦性麻痺兒童於接受懸吊式跑步機行走訓練後在步行之速度、步距、單腳站立期、雙腳站立期與粗大動作功能評量之躺/翻身、站、走/跑/跳、總得分與接受基準期的一般治療活動訓練後有統計上顯著之差異。因此懸吊式跑步機行走訓練，可以改善部分痙攣型腦性麻痺兒童的步態及動作功能表現。然而由於參與實驗的個案數較少，因此在作推論時需格外小心。

　　Cerebral palsy (CP) is a clinical syndrome, which is characterized with disorder of posture and motor control. Independence in motor function and ambulation is a big concern for the family of the children with CP. How to improve the CP children’s ambulatory ability as well as their motor function is considered the primary focus of most therapeutic interventions and is worth scientific investigations. According to the motor control and motor learning theory, learning is task specific. Any skill should be looked as a task. The best way to learn a task is to repetitively practice the task itself. Treadmill training provides a continuous and repetitive gait cycle training, which, when coupled with additional support of body weight by means of a suspension belt, would allow the subjects to perform complete gait cycles similar to floor walking. The purpose of this study was to investigate the effect of treadmill and suspension gait training on floor walking and gross motor function in children with spastic CP. A matched, blind and block randomized experimental design was adopted for the study. The study consisted of two phases (phase A, phase B), each lasting for 12 weeks. During phase B, subjects will perform gait training on a motor-driven treadmill with suspension for up to 20 minutes a session, two to three sessions a week, for a total of 12 weeks. During phase A subjects just performed their regular therapeutic activities, except treadmill and suspension training. Eight children met the recruitment criteria of our study. Half of the subjects were randomly determined to receive phase A first (group A-B) and the other half to receive phase B first (group B-A). All subjects received pre-training, midterm and post-training evaluation for muscle tone, selective motor control, gross motor function and gait performance. The results showed that there were statistical significant differences in velocity, stride length, single limb support, and double limb support of gait temporal-spatial parameters and dimension A, D, E, and total scores of Gross Motor Functional Measurement in children with CP after treadmill gait training. No effect of muscle tone and selective motor control were noted. These results suggest that treadmill with suspension system gait training could improve the gait pattern and motor function in some children with spastic CP. However, due to the small sample size, the generalization of the results of the study is limited.

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