作业训练治疗精神发育迟滞患儿精细运动障碍28例

目的：了解作业治疗对于精神发育迟滞(mental retardation，MR)患儿精细运动功能的作用。方法：选择2002-08／2003-03收治的28例MR患儿，男15例，女13例；平均年龄45个月，其精细运动发育商(fine motor quotients，FMQ)均在90以下。对他们均进行3个月作业治疗，治疗前后分别用Peabody精细运动发育评估量表[包括：抓握标准分(standard score for grasping，Grs)和视觉，运动统合标准分(standard score for visual-motor integration，VIs)]进行评估。结果：作业治疗后精细运动功能较治疗前有显著改善(FMQ74．64&;#177;11．2和84．0&;#177;14．1，t=6．66，P&;lt;0．001；Grs6．1&;#177;2．6和7．8&;#177;2．8，t=4．98，P&;lt;0．001；Vls5．5&;#177;1．9和7．0&;#177;2．4，t=5．92，P&;lt;0．001)；在作业治疗前后，精细运动功能的两个能区之间均无显著性差异(治疗前t=1．011，P=0．317；治疗后t=1．177，P=0．244)，但是有着显著的相关(治疗前r=0．410，P=0．03；治疗后r=0．601，P=0．001)；作业治疗后两个能区的月龄差(月)都显著降低(抓握能区：8．74&;#177;15．74，t=3．134，P=0．005；视觉-运动统合能区：11．43&;#177;14．84，t=4．863．P&;lt;0．001)。结论：作业治疗可以显著提高MR患儿的精细运动功能。     

儿童精神发育迟滞的康复治疗及其预后初探

目的：探讨康复治疗对儿童精神发育迟滞的影响，并对患儿的预后进行初步研究。方法：采用K式发育量表对51例精神发育迟滞的患儿进行综合评价，对其中9例患儿进行了临床对照性研究，以观察干预组患儿的疗效。结果：（1）经过半年的康复治疗并辅以有效的家庭教育，干预组较对照组患儿运动姿态的发育指数有明显提高（P＜0．05）；在认知、语言方面的发育指数及总发育指数方面，干预组与对照组之间有非常显著性差异（P＜0．001）。（2）诊断时患儿的年龄越小，其发育指数就越高（P＜0．001）。（3）母亲的文化程度≥高中时，其患儿的诊断年龄明显小于母亲的文化程度≤初中患儿的诊断年龄（P＜0．001）。结论：早期诊断，早期干预可明显提高精神发育迟滞患儿的发育指数，从而减轻残疾的发生；母亲的文化程度对患儿的预后起着至关重要的作用。     

精神发育迟滞患儿620例病因学探讨

精神发育迟滞(mentai retardation，MR)是严重危害儿童身心健康，是一个严重的社会问题。对确诊为MR的620例患儿进行病因学探讨，是否可减少或防治MR患儿。     

感觉统合训练治疗小儿精神发育迟滞的效果

目的 探讨感觉统合训练对精神发育迟滞患儿的临床疗效。方法 选取2017年1月至2019年1月郑州大学附属郑州中心医院收治的106例精神发育迟滞患儿为研究对象,按照随机数表法分为研究组和对照组,每组53例。对照组给予常规引导训练,研究组给予感觉统合训练,比较治疗前及治疗3个月后,两组患儿的智力水平[韦氏儿童智力量表(WISC-IV)]、社会行为能力[Achenbach儿童行为量表(CBCL)]变化,分析两组患儿的疗效差异。结果 治疗3个月后,研究组WISC-IV评分和CBCL量表社会能力评分均有显著提升,且明显高于同一时间对照组(P 0. 05);两组患儿CBCL量表行为问题评分均较治疗前有显著下降,且研究组评分明显低于同一时间对照组(P 0. 05);研究组治疗总有效率(88. 46%,46/52)明显高于对照组(67. 93%,36/53),差异有统计学意义(P 0. 05)。结论 感觉统合训练应用于精神发育迟滞患儿可取得良好临床疗效,有利于促进患儿智力及社会行为能力改善。     

22例儿童精神发育迟滞病因诊断分析

调查分析了 2 2例儿童精神发育迟滞的病因。     

精神发育迟滞患儿76例脑电图分析

目的 探讨精神发育迟滞患儿的临床症状与脑电图的关系,为临床诊治提供依据.方法 对76例精神发育迟滞患儿进行脑电图检查分析.结果 76例患儿中,6.58%脑电图正常(均为轻、中度精神发育迟滞患儿),11.84%边缘状态,26.32%轻度异常,31.58%中度异常,23.68%重度异常,异常率为93.42%;31例伴精神障碍症状患儿中,6.45%脑电图正常,19.35%轻度异常,51.61%中度异常,22.58%重度异常,异常率为93.55%.结论 精神发育迟滞患儿脑电图异常与智力水平呈明显正相关,病情越严重脑电图异常阳性率越高.     

精神发育迟滞患儿运动发育特点初探

目的探讨精神发育迟滞儿童的运动发育特点。方法 6~36月龄精神发育迟滞患儿430例采用Peabody运动发育量表(PDMS-2)和Gesll发育量表(GDS)进行评定。结果精神发育迟滞患儿的粗大运动发育商和精细运动发育商及总体发育水平均落后,且轻、中、重度之间有非常显著性差异(P<0.01);PDMS-2各项标准分均与GDS适应性发育商明显相关(P<0.01);不同智力发育水平患儿的粗大运动项标准分与精细运动发育商明显相关(P<0.01),精细运动项标准分与粗大运动发育商明显相关(P<0.01)。结论精神发育迟滞儿童粗大和精细运动发育均落后,智力发育水平与运动发育水平相关,智力发育迟缓患儿的粗大运动和精细运动发育相关性。     

精神发育迟滞患儿620例病因学探讨

背景:精神发育迟滞(mentairetardation,MR)是严重危害儿童身心健康,是一个严重的社会问题。对确诊为MR的620例患儿进行病因学探讨,是否可减少或防治MR患儿。目的:对620例MR患儿的病因进行分类比较,并针对MR的先天性和后天性病因提出早期干预措施。设计:随机抽样法,病例对照研究。单位:辽宁省锦州市儿童医院儿保科。对象:研究组为2000-02/2004-01辽宁省锦州市儿童医院儿保门诊就诊的6320例患者中确诊为MR的620例为对象,诊断标准主要参考《现代儿童精神医学》诊断标准,故18岁以下就诊者均为探讨对象进行病因学探讨。方法:根据不同年龄选…     

BAEP在精神发育迟滞患者中的应用

精神发育迟滞（ｍｅｔａｌｒｅｔａｒｄａｔｉｏｎ，ＭＲ）又称智力低下，是导致人类残疾最为严重的疾病之一。按照ＷＨＯ推荐标准，我们对１９９５年１０月～１９９６年１２月来院就诊的４８例ＭＲ患儿进行了脑干听觉诱发电位（ＢＡＥＰ）测定，结果报告如下：本组研究对象：男性２８例，女性２０例，年龄３～８岁，平均年龄６岁。由心理专业研究生按韦氏学前智力表（１９８６）及左启华等修订的《婴儿－初中学生社会生活能力量表》测得轻度智力低下１３人，中度低下２４人，重度低下９人，极重度２人。随机选３５名４～６岁正常儿童为对照…     

精神发育迟滞的细胞遗传学研究

精神发育迟滞 (ＭＲ)或智能发育不全是指 18岁以前各种原因引起的中枢神经系统发育受阻 ,以智力低下为主要表现的综合征。本文对 2 2 9例ＭＲ患儿进行了细胞遗传学研究 ,以探讨ＭＲ的病因。1　对象与方法1.1　对象　对 1985～ 2 0 0 1年 8月前来本院遗传咨询门诊就诊的 2 2 9例 0～ 14岁 ,中、重度以上智力低下的ＭＲ患者进行染色体检查及家系调查。1.2　方法　按本院常规染色体检查方法 :采外周血淋巴细胞培养 ,常规制片 ,Ｇ显带计数 30个分裂相 ,分析3～ 5个核型 ,发现嵌合体者 ,计数分析 10 0个核型。2　结果2 2 9例中染色体异常者 88例 …     

小组式作业治疗对脑瘫患儿精细运动功能影响的临床研究

目的:探讨小组作业治疗对脑瘫患儿精细运动功能的影响。方法:脑瘫患儿60例随机分为观察组和对照组各30例,2组均进行常规作业治疗,观察组在此基础上加用小组式作业治疗。治疗前后应用精细运动功能评估量表(FMFM)及Peabody精细运动发育量表(PDMS-FM)进行评定。结果:治疗3个月后,2组PDMS-FM各项评分及FMFM评分均较治疗前明显提高(P0.05),且观察组较对照组提高更显著(P0.05)。结论:小组式作业治疗能有效提高脑瘫患儿精细运动功能。     

Effects of occupational therapy services on fine motor and functional performance in preschool children.

PURPOSE: This study examined how performance components and variables in intervention influenced fine motor and functional outcomes in preschool children. METHOD: In a sample of 44 preschool-aged children with fine motor delays who received occupational therapy services, eight fine motor and functional performance assessments were administered at the beginning and end of the academic year. Data on the format and intervention activities of each occupational therapy session were recorded for 8 months. RESULTS: The children received a mean of 23 sessions, in both individual and group format. Most of the sessions (81%) used fine motor activities; 29% addressed peer interaction, and 16% addressed play skills. Visual motor outcomes were influenced by the number of intervention sessions and percent of sessions with play goals. Fine motor outcomes were most influenced by the therapists' emphasis on play and peer interaction goals; functional outcomes were influenced by number of sessions and percent of sessions that specifically addressed self-care goals. CONCLUSION: The influence of play on therapy outcomes suggests that a focus on play in intervention activities can enhance fine motor and visual motor performance.     

Roles and functions of occupational therapy in mental health

Within the scope of general psychiatry, occupational therapy personnel work in a broad range of practice areas and settings. Services are provided to children, adolescents, adults, and the elderly of all functional levels and diagnostic categories, in institutional, community-based, partial hospitalization, residential treatment, and forensic psychiatry programs. In all programs, the focus is goal-directed use of time, energy, interest, and attention to foster adaptation and productivity, minimize pathology, and promote the maintenance of health.     

Peabody精细运动发育量表在脑病患儿中的应用

目的了解作业治疗前后脑性瘫痪 (CP)和精神发育迟滞 (MR)患儿的精细运动功能变化 ,判断Peabody精细运动发育量表 (PDMS FM)在脑病患儿中的应用价值。方法选取本院康复中心CP患儿 2 2例和MR患儿 2 8例 ,观察作业治疗前后的精细运动功能变化 ,用PDMS FM测试。结果经作业治疗后 ,临床观察患儿的精细运动功能都有明显改善 ;PDMS FM测试分析结果为 :CP和MR患儿作业治疗前的精细运动功能无显著性差异 (P >0 .0 5) ;MR患儿的精细运动功能在治疗后有显著改善 (P <0 .0 0 1 ) ,CP患儿的精细运动功能虽有提高 ,但与治疗前无显著性差异 (P >0 .0 5)。结论Peabody精细运动发育量表可以用来评定脑病患儿的精细运动功能 ,尤其适用于MR患儿 ;但此法对于CP患儿在较短时间内的精细运动功能细微变化 ,还有局限之处 ,需要进一步改良以满足临床工作的需要     

Evaluation of occupational therapy school-based consultation service for students with fine motor difficulties

PURPOSE: This paper describes a 2-year study that addressed the perceived occupational performance changes among students with fine motor difficulties receiving occupational therapy school-based consultation (OTSBC) services. METHOD: The sample included 52 stakeholders of students with fine motor difficulties who received occupational therapy services. Six exploratory focus groups and one participatory and action-based focus group were conducted with parents, teachers, occupational therapists, and Community Care Access Centre case managers. RESULTS: Results supported the benefits of OTSBC. Key concerns identified were the wait for service, confusion about service expectations, inadequate communication among stakeholders, school board issues, and constraints in the health care system. Recommendations identified were to train teachers, provide early intervention, address service delivery issues related to health and education systems, and promote awareness of occupational therapy service and its effectiveness. PRACTICE IMPLICATIONS: Occupational therapists working with students with fine motor difficulties could consider providing formal education programs for teachers, promoting early intervention of fine motor problems, and communicating to stakeholders regarding the expectations and effectiveness of OTSBC.     

弱智儿童上肢关节活动感知能力与精细动作控制能力的相关性

目的研究弱智儿童的上肢关节活动感知能力、精细动作控制能力及它们的相关性。方法对比实验研究法。结果(1)弱智儿童在不同关节活动度(锐角、直角和钝角)感知上不存在统计学上的性别差异,但男童在3种关节活动度上的感知均比女童要差一些;(2)弱智儿童在3种关节活动度上的感知均显著落后于正常儿童,且随关节活动度的增大,感知能力愈差,达到极显著的程度(T锐角=-2.716,P<0.05;T直角=-3.471,P<0.01;T钝角=-5.493,P<0.01);(3)上肢精细控制能力上不存在性别差异,但弱智儿童的测试结果均比正常儿童要差,存在极显著的差异(T=-4.371,P<0.01);(4)精细动作控制能力与其关节活动感知能力之间存在显著相关。结论弱智儿童上肢关节活动感知能力与精细动作控制能力与正常儿童有较大的差距,加强动作技能训练是提高弱智儿童生存和生活质量的基础途径之一。     

作业疗法加促通技术对提高脑瘫患儿精细运动功能的研究

目的 探讨作业疗法加促通技术对提高脑瘫患儿精细运动功能的疗效.方法 将200例脑瘫患儿随机分为观察组(n=100)及对照组(n=100).对照组采用针灸、按摩、运动训练、物理因子疗法;观察组在此基础上配合作业疗法加促通技术,分别于治疗前后采用精细运动功能评估表(FMFM)对两组患儿进行评定,比较两组治疗效果.结果 治疗3个月后,两组患儿FMFM评分均较治疗前提高,与对照组比较,观察组FMFM值提高更显著(P＜0.01).结论 作业疗法加促通技术能显著提高脑瘫患儿精细运动功能,有效促进脑瘫患儿康复.     

Outcomes of an occupational therapy school-based consultation service for students with fine motor difficulties

PURPOSE: This paper reports on a study that was conducted to address the perceived occupational performance changes among school-aged children who received occupational therapy services for fine motor difficulties. It also addressed teacher awareness and the degree of implementation of occupational therapy recommendations by teachers. METHODS: The study sample included 91 school-aged children referred for occupational therapy services for fine motor difficulties. The children were assessed, before and after intervention. Outcome measures used were the Canadian Occupational Performance Measure (COPM) and the Teacher Awareness Scale (TAS). RESULTS: Significant change scores in both scales of the COPM were (Performance = 1.50, p < 0.001; Satisfaction = 1.92, p < 0.001). Regression analyses showed that lower teacher ratings of the students'performance and satisfaction of performance on the initial COPM resulted in significantly greater COPM change scores in the students'performance and satisfaction of performance at reassessment. The greater the degree of implementation of occupational therapy strategies by the teacher, the greater the COPM performance and satisfaction change scores. The greater the degree of teacher awareness of students'special needs resulted in greater COPM performance change scores. PRACTICE IMPLICATIONS: Teachers may benefit from more education regarding fine motor difficulties in children and how the implementation of occupational therapy strategies are helpful to improve children's fine motor difficulties.