肥胖儿童的运动处方

根据中国儿童有氧能力发育规律和肥胖儿童实测值,设计运动处方。强度为最大氧消耗的50％(现场控制心率为最大心率65％)。每天一小时,每周6天,共12周。运动方式为有氧运动,配合饮食指导和行为矫正。本方案安全、效果稳定,儿童乐于接受。     

儿童语言障碍的筛查

言语及语言是婴幼儿发展的核心能力,是认知能力和社会能力发展的标志,同时也能反映运动能力发育的某些特点.在儿童健康体检中,儿科医生应对各年龄段的儿童进行语言和言语能力的筛查评估.该文讨论如何在儿科进行语言障碍的筛查.     

儿童运动协调能力与生长发育水平的关联性研究

目的 初步探讨儿童运动协调能力与生长发育水平的关联性,为明确两者的因果关系,有效促进儿童的生长发育水平提供线索.方法 在上海市虹口、普陀、浦东3个区整群抽取10所幼儿园进行调查,共1099名儿童纳入分析,采用发育性协调障碍问卷(DCDQ)对儿童的运动协调能力进行评测.采用结构方程模型对运动协调能力与儿童生长发育水平之间的关联性进行分析,采用多组结构方程模型对不同性别、年龄和是否超重儿童的关联模型差别进行分析.结果 1099名研究对象中,男童561人(51％),女童538人(49％),3岁～组354人(32.2％),4岁～组441人(40.1％),5岁～组276人(25.2％),6～7岁组28人(2.5％).结构方程模型分析结果显示在儿童运动协调的功能表现中,精细运动、粗大运动和一般协调性均与生长发育水平呈正相关,具有统计学意义(标准化系数分别为0.36,0.40,0.37,P均＜0.001);多组结构方程模型分析结果显示不同性别和年龄的结构方程模型未发现明显差异(P均＞0.05),但超重和正常组的结构模型存在差异,其中仅粗大运动与儿童生长发育水平的结构系数存在组间差异(t值=1.697,P＜0.05).结论 儿童运动协调能力与生长发育水平存在一定关联性,并且超重和正常组儿童的粗大运动与生长发育水平的关联程度存在差异,为深入开展儿童生长发育水平影响因素的研究奠定了基础.     

哮喘儿童运动处方的探索

哮喘儿童的治疗目标之一是维持正常的活动水平,为了更好地了解哮喘与运动的关系,需要将哮喘儿童运动的相关研究进行归纳总结。该文通过总结运动对哮喘患者的益处、哮喘儿童运动现况、运动诱发性支气管收缩,以及哮喘儿童的运动处方的相关研究,使临床医生对哮喘儿童运动相关内容有更深入了解,从而更好地指导哮喘儿童进行运动。     

300例语言障碍儿童的智能发育水平分析

目的 了解语言障碍儿童的智能发育特征。方法 对300例语言障碍儿童进行Gesell发育量表评估,了解其运动能、应物能、言语能、应人能4个能区的发育商。结果 300例儿童的运动能平均发育商正常,应物能、言语能及应人能平均发育商均低于正常。运动能、应物能、应人能异常的比例分别为31.0%、49.0%、52.7%。言语能发育商与其他3个能区发育商显著正相关 （r分别为0.506、0.644、0.711,P < 0.01）。结论 语言障碍儿童往往不是单纯的语言落后,而是常伴随运动能力、适应行为及社交行为等方面的落后,应对其进行诊断性的智能发育评估并对伴随的其他发育异常问题进行全面干预。     

家庭环境与学龄前儿童发育性协调障碍的相关性

目的探讨家庭环境对学龄前儿童发育性协调障碍(DCD)的影响。方法按分层随机整群方法抽取4~6岁儿童1 727例,应用"儿童运动协调能力成套评估工具"对其进行DCD筛查;采用"城市学龄前儿童运动发育家庭环境量表"及自行设计的问卷评估儿童家庭环境状况。结果 117例儿童确诊为DCD。DCD组和正常对照组儿童在母亲文化程度、家庭结构的比较中差异有统计学意义。家庭环境因素中"让孩子管理自己的日常物品"和"包办孩子一切事务"两项得分在DCD组和正常对照组儿童之间差异有统计学意义。在控制儿童性别、年龄情况下,多因素logistic回归分析显示,"母亲文化程度""家庭结构""让孩子管理自己的日常物品"及"包办孩子一切事物"是影响儿童DCD发生的主要因素(均P0.05)。结论家庭环境对学龄前儿童DCD的发生存在影响,家长在养育孩子的过程中,不要包办孩子一切事务,应为儿童提供更多的管理自己日常生活的机会,以促进其早期运动协调能力的发展,预防DCD的发生。     

中国哮喘儿童运动处方的探索

运动是良医,是儿童正常生长发育的基石,是身心健康的必要条件,更是儿童哮喘管理的助力。运动处方是进行科学运动指导的有效方法,在国内存在空白,需要不断探索和优化运动处方,以提高哮喘儿童的运动水平。     

中国哮喘儿童运动处方30问

支气管哮喘是最常见的儿科慢性呼吸系统疾病之一,规律运动在哮喘的长期管理中有重要意义。中国哮喘儿童运动处方专家共识为临床医师指导患儿进行运动提供了科学的建议。本文整理了来自临床医师、患儿及监护人关于哮喘儿童进行运动的常见30个问题,并进行科普讲解,以期消除认识误区,明确科学运动的安全性和重要性,让每位哮喘儿童都有适合自己...     

肥胖儿童心血管功能状态评估

目的评判肥胖儿童的心血管功能状态。方法选择30例肥胖儿童以及50例年龄、性别相匹配的正常体质量儿童进行运动平板测试,比较两组间运动耐量、运动过程达亚极量心率的运动时间,以及持续T波电交替(TWA)的发生率。结果与正常体质量儿童相比,肥胖儿童运动耐量明显降低,且其达亚极量心率的运动时间也明显缩短,差异有统计学意义(P均0.01);肥胖儿童持续TWA发生率明显增高,差异也有统计学意义(P0.01)。结论肥胖儿童常伴发心血管功能障碍,提示在儿童时期就应关注肥胖可能导致的心血管损害。     

Williams综合征儿童早期运动发育特征

目的 分析Williams综合征（Williams syndrome,WS）儿童的早期运动发育情况,为临床早期干预提供依据。 方法 对2018年9月至2021年8月间59例0~24月龄的WS儿童的临床资料进行回顾性分析,其中男40例,女19例。根据Peabody运动发育量表（Peabody Developmental Motor Scale Ⅱ）测试结果,分析不同年龄患儿的运动发育情况。 结果 男女儿童月龄和运动商的比较差异均无统计学意义（P>0.05）。<6月龄组、6~<12月龄组、12~<18月龄组和18~24月龄组的粗大运动商分别为94±5、78±11、71±8、63±8,精细运动商分别为94±5、80±10、74±9、65±9,粗大运动商和精细运动商随着月龄增长逐渐下降（P<0.05）。<6月龄组、6~<12月龄组、12~<18月龄组和18~24月龄组的粗大运动发育异常率分别为0%、53%、87%、93%,精细运动发育异常率分别为0%、47%、67%、93%,粗大运动和精细运动发育异常率均随月龄增长而上升（P<0.05）。 结论 6个月以内WS儿童未表现出明显的运动能力落后,但随年龄增长其运动能力逐渐降低,运动发育迟缓率逐渐增加。因此必须做好该人群运动能力的随访工作,早期制订干预策略以减少运动发育迟缓的发生。 中国当代儿科杂志,2022,24（9）：984-987］     

The early motor milestones in infancy and later motor skills in toddlers: a structural equation model of motor development

The relationship between the achievement of early motor milestones in infancy and later motor development was studied in 130 children with (N = 66, 35 male/31 female) and without (N = 64, 31 male/35 female) familial risk for dyslexia. A structured parental questionnaire was used to assess motor development in infancy, and the Movement Assessment Battery for Children was used to assess motor skills at age 3.5 years. No differences were found at the group level and therefore the structural equation model was constructed by entering both groups simultaneously. An Early Body Control factor, computed from the infant data, explained 38% of the variance of the Gross Motor Skills factor at the age of 3.5 years. The results suggest a relationship between gross motor milestones in infancy and gross motor skills in toddler age. Unexpectedly, the early appearance of Early Hand Control skills in infancy had a negative association with the development of the gross motor domain at 3.5 years (explanation ratio was 9%). No significant connections between early and later fine motor skills were found. The mediating role played by postural control is discussed.     

The motor quotient. A method for the early detection of motor delay

A motor quotient was calculated by dividing the age of a child's best motor achievement by his or her chronologic age. A quotient less than 50 was said to predict gross motor delay (walking at or later than 24 months). Applying the quotient to 144 8- to 18-month-old children yielded a sensitivity of 87%, specificity of 89%, and overreferral and underreferral rates of 12%. By viewing motor development as a ratio, one is able to forecast motor delay.     

Use of the motor performance checklist to study motor outcomes in 5-year-olds

Aim:   To report findings about the Motor Performance Checklist (MPC) for 5-year-olds, a simple 12-item instrument for assessing gross and fine motor skills, in a research study of neurodevelopmental outcomes after neonatal events.
Methods:   We trained 10 examiners to use the MPC in a study of the outcomes of neonatal jaundice and dehydration in 339 5-year-old children. We compared MPC scores with those on the Wechsler Preschool and Primary Scale of Intelligence-Revised (WPPSI-R), the Beery–Buktenica Developmental Test of Visual-Motor Integration-Fourth Edition (VMI-4), and a standard neurological examination, and compared failure rates on each MPC item across examiners. Parent concerns about their child's development were addressed using the Parent Evaluation of Developmental Status (PEDS).
Results:   Children who 'failed' the MPC had 7–10 points lower mean scores on the WPPSI-R subscales ( P  = 0.001), 9–10 points lower mean scores on the VMI-4 subscales ( P  = 0.001), and were almost twice as likely to have a 'questionable' neurological examination score (adjusted OR 1.86, 95% CI 1.00–3.53, P  = 0.005). On the PEDS, only the concern about the use of arms and hands was significantly associated with MPC failure. We found significant sex differences on four of the 12 MPC items. We also found differences in failure rates by different examiners.
Conclusions:   MPC scores correlated with other measures of neurodevelopment. Because of different failure rates across examiners, examiner terms need to be included if it is used in research studies.     

Preventing motor vehicle injuries

Prevention of injuries to child passengers is a significant public health priority, as motor vehicle-related injuries remain a leading cause of death for children. Improvements in child restraint use have contributed to significant declines in child occupant mortality rates over the past 20 years. However, although overall restraint use has improved, many children are currently not optimally restrained for their age. Errors in installing and using child safety seats, as well as the premature graduation of children to vehicle safety belts, contribute to reducing the effectiveness of restraints for children. Further prevention of motor vehicle occupant injuries to children will require the combined approaches of engineering, education, and enforcement. This review presents current information regarding inappropriate restraint of children and highlights current engineering, education, and legislative efforts to improve child occupant protection.     

Cerebral palsy in Victoria: motor types, topography and gross motor function

Objectives:   To study the relationships between motor type, topographical distribution and gross motor function in a large, population-based cohort of children with cerebral palsy (CP), from the State of Victoria, and compare this cohort to similar cohorts from other countries.
Methods:   An inception cohort was generated from the Victorian Cerebral Palsy Register (VCPR) for the birth years 1990–1992. Demographic information, motor types and topographical distribution were obtained from the register and supplemented by grading gross motor function according to the Gross Motor Function Classification System (GMFCS).
Results:   Complete data were obtained on 323 (86%) of 374 children in the cohort. Gross motor function varied from GMFCS level I (35%) to GMFCS level V (18%) and was similar in distribution to a contemporaneous Swedish cohort. There was a fairly even distribution across the topographical distributions of hemiplegia (35%), diplegia (28%) and quadriplegia (37%) with a large majority of young people having the spastic motor type (86%).
Conclusions:   The VCPR is ideal for population-based studies of gross motor function in children with CP. Gross motor function is similar in populations of children with CP in developed countries but the comparison of motor types and topographical distribution is difficult because of lack of consensus with classification systems. Use of the GMFCS provides a valid and reproducible method for clinicians to describe gross motor function in children with CP using a universal language.     

Acute motor neuropathy with pure distal involvement – A case report of multifocal motor neuropathy

Multifocal Motor Neuropathy is an acquired pure motor neuropathy seen principally in adults and usually responds to treatment with intravenous immunoglobulin. We report a 12 year old boy with marked distal weakness in both upper and lower limbs with no proximal involvement. These clinical features appear to be distinct from more common inflammatory childhood neuropathies and are in keeping with a diagnosis of Multifocal Motor Neuropathy. Confirming the diagnosis, serial nerve conduction studies showed a pattern of pure motor conduction block with normal sensory potentials. To our knowledge this is only the second case report of this condition occurring in childhood.     

The motor development of fat babies

The motor development of a group of fat babies was compared with that of a group of normal weight babies. A significant correlation was found between excessive weight and gross motor delay. Over the ensuing year, both weight and development reverted to normal in the majority of infants. The possible relationship between observations is discussed, and a plea is made that a comprehensive evaluation of the motor-delayed overweight infant be performed before concluding that the delay is due solely to the excessive weight.