Evaluation of gross motor abilities and self perception in children with amblyopia

Purpose. The present study evaluates gross motor abilities and self perception about the physical abilities of pre-school children with amblyopia, in comparison to their unaffected peers.

Method. Twenty-two children with amblyopia, and 25 children with normal vision, aged 4 - 7, were included in this study. Gross motor abilities were evaluated by the Movement Assessment Battery for Children (MABC). The Pictorial Scale of Perceived Competence and Social Acceptance for Young Children were used to measure physical self perception. Parents completed a questionnaire about everyday situations revolving around the child's balance and posture abilities.

Results. Amblyopic children performed significantly worse than the controls according to the MABC subtests and the parents' questionnaire total score. In the scale of perceived competence evaluation the amblyopic children had lower scores in half of the items as well as in the total mean score, but the differences between the groups were not significant. Among the study group, significant correlations were found between several items in the parents' questionnaire and the children's' mean balance score in MABC.

Conclusions. Amblyopia may negatively impact children's motor abilities as expressed by the objective measures in daily living, while self perception is less affected.     

不同类型脑性瘫痪儿童粗大运动功能的差异及对策

目的：通过对3—7岁的痉挛型和手足徐动型脑性瘫痪（CP）患儿的运动障碍特点进行分析和干预，以探讨该年龄段痉挛型和手足徐动型CP患儿粗大运动功能的差异及对策。方法：对27例痉挛型脑瘫患儿（A组）及12例手足徐动型脑瘫患儿（B组）在人选时及治疗6个月后，分别应用粗大运动功能测量量表（GMFM）进行测量，比较两组人选时，6个月后以及治疗前后各功能区评分的改变。结果：A组患儿在GMFM量表B区、C区、D区、E区得分及总分均较B组为高，A组患儿GMFM涉及上肢的和不涉及上肢的任务的平均分、动态任务的平均分均较B组为高，两组患儿治疗后均较治疗前有改善，差异有显著性（P〈0．05）；两组患儿GMFM静态任务平均分，治疗前后各区得分和总分改变量差异无显著性（P〉0．05）。结论：痉挛型和手足徐动型CP患儿的粗大运动功能表现不同．手足徐动型脑瘫患儿粗大运动功能障碍较痉挛型为重，对于不同类型的脑瘫患儿需针对其运动障碍特点采取不同治疗方式及对策。     

Active exercise interventions improve gross motor function of ambulant/semi-ambulant children with cerebral palsy: a systematic review

Purpose: Evaluate effectiveness of active exercise interventions for improving gross motor activity/participation of school-aged, ambulant/semi-ambulant children with cerebral palsy (CP).

Method: A systematic review was conducted following PRISMA guidelines. Five databases were searched for papers including school-aged children with CP, participating in active, exercise interventions with gross motor outcomes measured at the Activity/Participation level. Interventions with previous systematic reviews were excluded (e.g. hippotherapy). Evidence Level and conduct were examined by two raters.

Results: Seven interventions (34 studies) met criteria. All studies reported on gross motor function, however, a limited number investigated participation outcomes. Strong positive evidence was available for Gross Motor Activity Training (n= 6, Evidence Level II–IV), and Gross Motor Activity Training with progressive resistance exercise plus additional physiotherapy (n?=?3, all Evidence Level II). Moderate positive evidence exists for Gross Motor Activity Training plus additional physiotherapy (n?=?2, all Evidence Level II) and Physical Fitness Training (n?=?4, Evidence Level II–V). Weak positive evidence was available for Modified Sport (n?=?3, Evidence Level IV–V) and Non-Immersive Virtual Reality (n?=?12, Evidence Level II–V). There was strong evidence against Gross Motor Activity Training plus progressive resistance exercise without additional physiotherapy (n?=?4, all Evidence Level II).

Interpretation: Active, performance-focused exercise with variable practice opportunities improves gross motor function in ambulant/semi-ambulant children with CP.

• Implications for rehabilitation

• Active exercise interventions improve gross motor function of ambulant/semi-ambulant children with cerebral palsy.

• Gross Motor Activity Training is the most common and effective intervention.

• Practice variability is essential to improve gross motor function.

• Participation was rarely measured and requires further research, particularly in interventions that embed real-world participation opportunities like Modified Sport.

     

A comparison of motor abilities and perceived self-efficacy between children with hearing impairments and normal hearing children

Purpose. The present study evaluates the differences in motor abilities and in self-efficacy between children with hearing impairments and children with normal hearing.

Method. Participants were 48 children, aged 5 – 9 years, including 22 with hearing impairments and 26 with normal hearing. Motor abilities were evaluated by the Children Activity Scales for Teachers (ChAS-T) and the Movement Assessment Battery for Children (MABC). Self-efficacy was evaluated using the Perceived Efficacy and Goal Setting System (PEGS).

Results. Children with hearing impairments showed significantly lower motor abilities, according to the ChAS-T and the MABC. No significant differences were found between the groups in regard to the self-efficacy level according to most evaluated scales. Results for the study group revealed a significant correlation between the ChAS-T and the static balance score of the MABC. In both groups, significant correlations were found between motor abilities and child's age.

Conclusions. While children with hearing impairments may show lower motor abilities, as expressed by the MABC and the ChAS-T, their self-efficacy is similar to that of their normal hearing peers.     

160例儿童弱视治疗效果分析

目的：探讨儿童弱视治疗效果及其相关因素。方法：按照全国统一弱视诊断标准，收集160例（180眼）儿童弱视患者，治疗前进行散瞳检影、矫正视力、弱视类型和程度、注视性质检查，采用准确验光配戴矫正眼镜法和光学药物压抑疗法（远、近距离压抑和微量压抑）联合遮盖疗法，同时用弱视治疗仪进行综合治疗。随访时间1～5年，平均2．3年。结果：治愈162眼（90％），进步18眼（10％）。不同年龄患者疗效比较差异无显著意义（P〉0．05）；中心注视患者的疗效明显优于旁中心注视患者（P〈0．01）；不同弱视程度患者的疗效差异有显著性意义（P〈0．01）；屈光不正性和屈光参差性弱视患者的疗效明显优于斜视性和形觉剥夺性弱视患者（P〈0．01）。结论：儿童弱视，早期发现，早期干预均可获得满意疗效。     

Factors associated with nutritional status and motor development among young children

This study was conducted to investigate the nutritional status and gross motor development of children in a suburban area of northeast China and the factors influencing these issues. A total of 189 children aged 1–3 years and their mothers participated. Child and maternal length/height and weight were measured. Information was collected on basic characteristics, household monthly income, child's age at achievement of six gross motor milestones, and feeding practices by interviewing the mothers/caregivers. The prevalence of overweight (using World Health Organization growth standards) and delayed achievement of walking alone among the children was 27% and 12.7%, respectively. The independent predictors of increased odds for being overweight were middle household income and high dietary diversity score. Exclusive breastfeeding was associated with lower odds of children being overweight. Delayed solid feeding initiation was associated with increased odds of delay in walking alone for the children. Breastfeeding predicted reduced odds of this issue. These findings suggest that nutritional intervention and childcare education, such as breastfeeding promotion, improved diet quality, and the timely introduction of solid food, could improve growth and development among young children in suburban northeast China.     

婴儿游泳对后天运动技能的影响

目的探讨婴儿游泳对后天运动技能的影响。方法选择曾经在我院预防保健科参加游泳训练的4岁正常幼儿50人为游泳组,另外同等条件未参加游泳训练的幼儿50人为对照组,运用儿童运动评估成套工具（M—ABC）对入组婴儿开展回顾州：分析。结果游泳组M—ABC总分（4．5±3．2）分,对照组（6．4±4．1）分,两组比较差异无统计学意义（P〉0．05）,其中手部精细操作、穿珠子、球类技巧、静态动态平衡中的单腿平衡评分比较差异有统计学意义。结论早期参加婴儿游泳训练,可以提高婴儿后天的精细动作的协调能力、大运动协调能力和增强自身的平衡感觉。     

痉挛型双瘫脑瘫儿童粗大运动功能与脊柱活动度的相关性

目的 探讨痉挛型双瘫脑瘫儿童粗大运动功能与脊柱运动能力之间的关系。     

马术治疗对脑性瘫痪儿童粗大运动功能疗效的系统评价与Meta分析

目的：系统评价马术治疗（EAT）对脑性瘫痪（CP）儿童粗大运动功能的疗效。方法：计算机检索Medline、EmBase、Cochrance、SciVerse ScienceDirect、Web of science、Pubmed、Pedro、万方医学、知网医学、中国生物医学文献服务系统数据库检索时限为建库至2019年8月,由２位评价员对符合纳入标准的文献采用PEDro量表进行质量评估。对纳入的文献进行系统评价,并提取粗大运动功能评估量表(GMFM-66;GMFM-88)的标准分以及GMFM-88中的B（坐）、D(站)、E（走、跑、跳）维度分数等数据,采用Revman5.3软件进行Meta分析。结果：共纳入7篇文献进行系统评价,其中5篇数据纳入Meta分析,共288例。Meta分析显示GMFM-66［SMD =0.52,95％CI（0.28~0.76）,P<0.0001］、GMFM-88［SMD =0.56 ,95％CI(0.25~0.86), P=0.0003］和B维度［SMD=0.31,95％CI（0.02~0.61）,P=0.04］、D维度［SMD=0.61,95％CI（0.28~0.95,P=0.0004］、E维度［SMD=0.55,95％CI（0.25~0.85）,P=0.0004］。结果表明,实验组与对照组结果差异具有统计学意义,即EAT可以显著改善CP儿童粗大运动功能。结论：基于系统评价及Meta分析结果,EAT可以显著改善CP儿童粗大运动功能,可以作为CP儿童物理治疗的参考治疗方法。     

Alberta婴儿运动量表与Peabody粗大运动发育量表在高危儿中的预测能力研究

目的:探究Alberta婴儿运动量表(Alberta Infant Motor Scale, AIMS)及Peabody粗大运动发育量表(Peabody Developmental Gross Motor Scale-2, PDGMS-2)在小月龄高危婴儿发育监测中的灵敏度和特异度。方法:58例符合纳入标准的高危儿加入本研究,平均月龄(4.46±0.97)个月(月龄范围2—6个月)。3名有AIMS和PDGMS-2评估经验的治疗师加入本研究。同一评估者对同一婴儿分别进行AIMS和PDGMS-2评估,并记录评估结果。47例高危儿在2岁时接受随访检查。将2岁时的诊断结果与6个月内的量表评估结果进行对应分析,计算灵敏度、特异度、阳性预测率和阴性预测率。结果:在对小于6月龄的高危儿进行评估时,AIMS的灵敏度是0.857、特异度是0.731、阳性预测率是0.720、阴性预测率是0.864。PDGMS-2的灵敏度是0.524、特异度是1.000、阳性预测率是1.000、阴性预测率是0.722。结论:针对高危婴儿运动发育的评测,AIMS具有较高的敏感度,适用于高危儿的早期监测;但是其特异度不高,提示对AIMS异常的婴儿应进行动态监测,谨慎判定。     

The efficacy of GMFM-88 and GMFM-66 to detect changes in gross motor function in children with cerebral palsy (CP): a literature review

Abstract

Aim: The purpose of this study was to review published research on the use of the Gross Motor Function Measure (GMFM-88) and (GMFM-66) as outcome measures to determine if these tools detect changes in gross motor function in children with cerebral palsy (CP) undergoing interventions. Methods: A comprehensive literature search was conducted using Medline and PubMed to identify studies published from January 2000 through January 2011 that reported the accuracy of GMFM-88 and GMFM-66 to measure changes over time in children with CP undergoing interventions. The keywords used for the search were “GMFM” and “CP”. Two of the authors (M.A. and S.B.) reviewed the titles and abstracts found in the databases. The methodological quality of the studies was assessed by using the Critical Review Form-Quantitative Studies. Results: Of 62 papers initially identified, 21 studies fulfilled the inclusion criteria. These articles consist of three longitudinal studies, six randomized controlled trials, four repeated measure design, six pre–post test design, a case series and one non-randomized prospective study. The included studies were generally of moderate to high methodological quality. The studies included children from a wide age range of 10?months to 16?years. According to the National Health and Medical Research Council, the study designs were level II, III-2, III-3 and IV. Conclusion: The review suggests that the GMFM-88 and GMFM-66 are useful as outcome measures to detect changes in gross motor function in children with CP undergoing interventions.

• Implications for Rehabilitation

• Accurate measurement of change in gross motor skill acquisition is important to determine effectiveness of intervention programs in children with cerebral palsy (CP).

• The Gross Motor Function Measure (GMFM-88 and GMFM-66) are common tools used by rehabilitation specialists to measure gross motor function in children with CP.

• The GMFM appears to be an effective outcome tool for measuring change in gross motor function according to a small number of randomized control studies utilizing participant populations of convenience.

     

小于3岁痉挛型脑性瘫痪儿童粗大运动与精细运动发育的相关性研究

目的比较小于3岁痉挛型脑性瘫痪儿童粗大运动与精细运动发育之间的相关性。方法以同时接受粗大运动功能测试量表（GMFM）评定和精细运动功能评定量表（FMFM）评定的193例小于3岁的痉挛型脑性瘫痪儿童为研究对象，比较GMFM各项分值与FMFM分值在不同月龄和类型患儿中的相关程度，通过多元逐步回归分析确定GMFM5个功能区分值对FMFM分值的影响程度。结果在不同月龄和类型的脑性瘫痪患儿中，GMFM各项分值与FMFM分值具有良好的相关性（r=0．26～0．85，P〈0．05），多元逐步回归分析结果显示GMFM的A区和B区分值对FMFM分值的影响力较大，校正决定系数为0．748，A区的作用更为强烈。结论小于3岁的痉挛型脑性瘫痪儿童的粗大运动与精细运动存在着良好的相关性，对不同年龄和类型的脑性瘫痪儿童都应该重视粗大运动与精细运动训练相结合，同时必须加强基本运动功能训练。     

不同出生体重脑瘫高危儿婴儿期粗大与精细运动技能发育特征及其相关性研究

目的: 了解不同出生体重脑瘫高危儿婴儿期粗大与精细运动技能发育的结构特征及其相关性。方法: 以接受Peabody运动发育量表中的粗大运动（GM）和精细运动（FM）技能评估量表评定的522例年龄小于1岁的脑瘫高危儿为研究对象,通过多变量方差分析和t检验确定不同出生体重脑瘫高危儿婴儿期运动技能发育的结构特征,采用Pearson相关分析比较其相关程度。结果: 不同出生体重组别间患儿GM、FM各项原始分和标准分值比较,差异均无显著性意义（P>0.05）。患儿的姿势、移动、抓握、视觉-运动整合项标准分值均明显低于反射项（t值分别为23.82、32.27、37.06、26.92,P<0.001）。不同出生体重组别患儿反射、姿势和移动项标准分值与FM分值具有良好相关性（r=0.39-0.85,P<0.01）,且抓握、视觉-运动整合项标准分值与GM分值也有良好相关性（r=0.55-0.85,P<0.01）。结论：不同出生体重脑瘫高危儿的反射发育明显好于姿势、移动、抓握、视觉-运动整合发育,其粗大运动与精细运动技能发育存在良好的相关性。     

The effects of Kinesio® taping on sitting posture,functional independence and gross motor function in children with cerebral palsy

Purpose:?The aim of this study was to investigate the effects of Kinesio® tape (KT) application on sitting posture, gross motor function and the level of functional independence.

Method:?The study included 31 cerebral palsied children scored as level III, IV or V according to gross motor functional classification system (GMFCS). Children were randomly separated into two groups as study (n == 15, receiving KT and physiotherapy) and control (n == 15, receiving only physiotherapy). KT application was carried out for 12 weeks. Gross motor function measure (GMFM), functional independence measure for children (WeeFIM) and Sitting Assessment Scale (SAS) were used to evaluate gross motor function, independency in the activities of daily living and sitting posture, respectively.

Results:?Compared to initial assessments, both groups showed a significant difference in parameters of GMFCS sitting subscale, GMFCS total score and SAS scores (p < 0.05). At the end of 12 weeks, only SAS scores were significantly different in favour of the study group when the groups were compared (p < 0.05). Also, post-intervention WeeFIM scores of the study group were significantly higher compared to initial assessment (p < 0.05), however, no difference was detected in the control group (p > 0.05).

Conclusions:?No direct effects of KT were observed on gross motor function and functional independence, though sitting posture (head, neck, foot position and arm, hand function) was affected positively. These results may imply that in clinical settings KT may be a beneficial assistive treatment approach when combined with physiotherapy.     

任务导向性训练对痉挛型脑性瘫痪儿童粗大运动功能及步行功能的疗效

目的:研究任务导向性训练对痉挛型脑性瘫痪(脑瘫)儿童粗大运动功能及步行功能的疗效。方法:2013年3—12月在佳木斯大学附属第三医院明确诊断,并收入住院治疗的3—12岁痉挛型脑瘫儿童40例进行随机分组,对照组20例,试验组20例。对照组采用常规康复训练,试验组采用常规康复训练结合任务导向性训练,两组均治疗3个月。在治疗前后对患儿分别应用粗大运动功能量表(gross motor function scale assessment,GMFM-88项)、足印分析法、10m步行测试(10 meters walk test,10MWT)、1min步行测试(1 minute walk test,1MWT)进行评定。结果:两组治疗后GMFM-88项D区和E区评分、跨步长和步宽、10m步行时间及1min步行总距离均优于训练前(P0.05),试验组优于对照组(P0.05)。结论:任务导向性训练有利于提高痉挛型脑瘫儿童的粗大运动功能,改善步态并提高步行的速度和耐力,有助于患儿适应和参与学校及社会环境。     

儿童弱视训练中心的管理模式探讨

目的探讨儿童弱视训练中心的标准化管理方法。方法对训练中心硬件及软件进行改进。(1)硬件。包括医院候诊环境、诊室、训练室等;(2)软件。包括训练跟踪管理、就诊流程、健康教育处方等,以提高弱视患者的依从性。结果弱视患儿的视力恢复有效率达到95.4%,基本治愈率为71.4%。结论儿童弱视训练中心模式提高了弱视训练的效果。     

感觉统合训练对高危儿粗大运动功能发育的影响

目的:探讨感觉统合训练在高危儿早期干预中对于粗大运动功能的影响。方法:收集进行早期干预的高危儿55例,随机分为观察组28例和对照组27例。观察组接受早期感觉统合训练和常规康复,对照组接受常规康复。治疗前和治疗3个月后,分别采用Alberta婴儿运动量表(AIMS)进行评估。结果:治疗3个月后,2组俯卧位、仰卧位、坐位、立位AIMS评分及总分均较治疗前显著提高(P0.01),且观察组俯卧位、仰卧位评分及总分均高于对照组(P0.05)。治疗后2组的坐位、立位AIMS评分比较差异无统计学意义。治疗后,2组AIMS百分位数水平较治疗前均明显提高(P0.05),观察组明显高于对照组(P0.05)。结论:经过早期感觉统合治疗,观察组的粗大运动发育水平在俯卧位、仰卧位及总体水平上较对照组有显著性意义上的进步;早期感觉统合训练对高危儿粗大运动功能的提高有明显效果。     

肌内效贴治疗对产伤性上干型臂丛神经损伤患儿运动功能发育的影响

目的:观察肌内效贴治疗对产伤性上干型臂丛神经损伤患儿运动功能发育的影响。方法:选取产伤性上干型臂丛神经损伤患儿20例,随机分成两组:对照组(n=10)进行感觉输入及常规康复训练,观察组(n=10)在对照组的基础上辅以肌内效贴治疗。治疗前和治疗6个月后对患儿进行下列评估:A、Mallet评分;B、臂丛功能综合评价;C、GMFM-A区评估;D、Peabody精细运动发育量表评估。结果:两组治疗后,A、B、C、D项评估结果均优于本组治疗前,差异均有显著性意义(P0.05)。两组治疗前,各项评估的组间差异均无显著性意义,治疗后,观察组A、B、C、D项评估结果均优于对照组,差异均有显著性意义(t=2.172,2.295,2.305,5.936;P=0.044,0.034,0.036,0.000)。结论:肌内效贴治疗可改善产伤性上干型臂丛神经损伤患儿上肢功能,并有助于患儿粗大、精细运动功能的发育。