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。     

感觉统合训练对改善农村地区学龄前儿童感觉统合失调的效果观察

[目的]探讨感觉统合训练治疗农村地区学龄前儿童感觉统合失调的疗效。[方法]选取感觉统合失调学龄前儿童120例,根据随机抽签原则分为治疗组与对照组各60例,治疗组根据疾病程度给予个体化的感觉统合训练,对照组给予常规行为干预训练,干预周期为3个月。[结果]治疗组的感觉统合能力和气质状况各维度评分均高于对照组(P<0.05);治疗组的总有效率高于对照组(P<0.05)。[结论]感觉统合训练对农村地区学龄前儿童感觉统合失调具有很好的干预效果,能促进患儿的康复与气质状况的提高。     

Perspectives on the status of sensory integration theory

Sensory integration theory has generated many studies over the past decade, and individuals who are evaluating the theory and its ramifications for treatment have started to draw conclusions based upon those studies. However, the theory underlying treatment has not been fully explored through research, nor have the bulk of the treatment effectiveness studies demonstrated the methodological and statistical power necessary to adequately accept or reject effectiveness. The purpose of this article is to examine how research on sensory integration therapy relates to the underlying theory of therapy, how it is guided by the theory, and how it can be used to evaluate and develop the theory. The perspective taken in this discussion is that of a professional who does not have the experience of practicing sensory integration treatment but who is informed through the published research in the area. It is hoped that the resultant simplicity and objectivity of the discussion will provide a useful analysis of the complex issues surrounding research in this area. Suggestions are given for improving the knowledge of "outsiders" about the theory and practice of sensory integration treatment through research.     

听觉统合训练对整体发育迟缓儿童语言及情绪-社会性的影响

目的:探讨听觉统合训练(auditory integration training,AIT)对整体发育迟缓(global developmental delay,GDD)儿童语言及情绪-社会性的治疗效果。方法:144例GDD儿童随机分成治疗组、对照组和空白对照组,每组轻度GDD 28例,中重度GDD 20例。运用脑干诱发电位仪行ASSR测试判定听觉敏感频率,数码听觉统合训练仪进行AIT治疗,采用0—6岁小儿神经心理发育检查表、AIT疗效调查表,治疗前后3个月语言发育商、总发育商评分差异及AIT治疗3个月后临床症状的变化来评估整体疗效。结果:治疗3个月后,治疗组中轻度GDD语言DQ、总DQ较治疗前明显提高(P0.001),而治疗组中中重度GDD患儿以及全部对照组中患儿语言DQ、总DQ较治疗前提高不明显,差异无显著性意义(P0.05),全部空白对照组语言DQ、总DQ较治疗前明显降低(P0.01,P0.05)。轻度GDD三组患儿治疗后3个月语言DQ、总DQ差异有非常显著性意义(P0.001),中重度GDD三组患儿治疗后3个月总DQ差异有显著性意义(P0.05)。治疗后两两比较显示:轻度GDD治疗组与空白对照组语言DQ、总DQ比较差异显著(P0.01,P0.01),中重度GDD治疗组与空白对照组总DQ比较差异显著(P0.05),轻度、中重度GDD对照组与空白对照组总DQ比较差异显著(P0.05),轻度GDD对照组与空白对照组语言DQ比较差异无显著性意义(P0.05)。AIT治疗3个月后在语言、社会交往上平均总有效率60.42%、72.92%,控制情绪能力平均总有效率20.83%。结论:AIT能促进轻度GDD儿童语言发育水平,提高GDD儿童社会交往能力及改善情绪。     

A meta-analysis of research on sensory integration treatment.

OBJECTIVE: The purpose of this study was to find whether existing studies of treatment using sensory integration approaches support the efficacy of these approaches. METHOD: With meta-analysis, the results of sensory integration efficacy research studies published from 1972 to the present were synthesized and analyzed. Sixteen studies were used to compare sensory integration effect with no treatment (SI/NT), and 16 were used to compare sensory integration effect with alternative treatments (SI/ALT). Overall average effect sizes, comparisons of the effect sizes for different dependent variables, and secondary factors associated with effect size variation were examined. RESULTS: The weighted average effect size of SI/NT studies was .29. However, there was a significant difference between the average effect sizes of the earlier studies (.60) and the more recent studies (.03). Of the outcome measures, larger effect sizes were found in the psychoeducational category (.39) and motor category (.40). Of SI/ALT studies, the average effect size was .09, not significantly different from zero. CONCLUSION: Three central conclusions can be made. First, in the SI/NT comparison, a significant effect was replicated for sensory integration treatment effects in earlier studies, but more recent studies did not show overall positive effects. Second, larger effect sizes were found in psychoeducational and motor categories. Third, sensory integration treatment methods were found to be as effective as various alternative treatment methods.     

感觉统合治疗改善青少年抑郁症的临床疗效观察

目的:观察感觉统合治疗改善青少年抑郁症的临床疗效。方法:选取2018年1—10月我院收治的青少年抑郁症患者80例,采用随机数字表法在知情、同意接受研究者分组的原则下将所有患者分为药物组(n=40)和感觉统合治疗组(n=40),药物组患者给予常规的抗抑郁药物左洛复,感觉统合治疗组在常规药物治疗的基础上给予感觉统合治疗,连续治疗12周。分别采用汉密尔顿抑郁量表(HAMD)、症状自评量表(SCL-90)、焦虑自评量表(SAS)、失眠严重度指数(ISI)、哥伦比亚-自杀严重程度评定量表(C-SSRS)、里克特自我伤害量表、临床疗效总评量表病情严重程度(CGI-SI)进行疗效评估。结果:治疗后两组患者的HAMD评分、SCL-90评分、SAS评分、ISI、C-SSRS自杀意念积极者数量、里克特自我伤害量表评分以及CGI-SI评分均随着治疗时间的延长而降低,而且感觉统合治疗组患者的HAMD评分、SCL-90评分、SAS评分,C-SSRS自杀意念积极者数量以及CGI-SI评分均显著低于对照组,差异具有显著性意义(P0.05);感觉统合治疗组不良反应的发生率明显低于对照组,差异有显著性意义(P0.05)。结论:感觉统合治疗能够明显改善青少年抑郁症患者的临床症状,降低HAMD评分、SCL-90评分、SAS评分、ISI、CSSRS自杀意念积极者数量、里克特自我伤害量表评分以及CGI-SI评分,且该方法安全性极好,值得在临床上广泛推广应用。     

心理护理在儿童感觉统合训练中的应用

目的:了解感觉统合失调儿童心理护理的内容与方法,探讨心理护理对儿童感觉统合训练疗效的影响。方法:对儿童感觉统合失调进行矫正的过程中进行的心理护理措施主要包括如下几个方面:①关爱儿童的身心需求,搞好儿童治疗室的硬件设施。②恰当的与家长进行心理沟通,解除焦虑和偏见;对儿童治疗树立起信心。③掌握儿童的心理需要和心理活动规律,进行相应护理:带教老师要以敏锐的眼光、细心观察儿童的心理活动,与其建立起良好的关系;注重语言效果,激发儿童训练兴趣;尊重儿童的人格,带教老师要付出爱心,耐心,宽容之心;遵循“以儿童教育儿童”的科学教育方法,引导儿童搞好同伴关系。④做好家长的心理辅导工作。结果:在对感觉统合失调儿童进行恰当的心理护理,可收到事半功倍的疗效。可使儿童在愉悦宽松的氛围中进行治疗,驱除心理压力、消除心理障碍。结论:心理护理是医用心理学的重要组成部分,也是独立的分支学科。在儿童少年精神医学领域中,儿童心理卫生占有举足轻重的地位。因此,关注儿童的心理需求,研究儿童的心理状态,是心理护理的职责之一;也是感觉统合训练中不可缺少的内容。它对改善儿童的大脑功能,促进儿童的脑发育和心理发育,起到了催化剂的作用。从而使儿童在身体、心理、社会适应和道德品质等方面得到全面、健康的发展。     

心理护理在儿童感觉统合训练中的应用

目的：了解感觉统合失调儿童心理护理的内容与方法，探讨心理护理对儿童感觉统合训练疗效的影响。方法：对儿童感觉统合失调进行矫正的过程中进行的心理护理措施主要包括如下几个方面：①关爱儿童的身心需求，搞好儿童治疗室的硬件设施。②恰当的与家长进行心理沟通，解除焦虑和偏见；对儿童治疗树立起信心。③掌握儿童的心理需要和心理活动规律，进行相应护理：带教老师要以敏锐的眼光、细心观察儿童的心理活动，与其建立起良好的关系；注重语言效果，激发儿童训练兴趣；尊重儿童的人格，带教老师要付出爱心，耐心，宽容之心；遵循“以儿童教育儿童”的科学教育方法，引导儿童搞好同伴关系。④做好家长的心理辅导工作。结果：在对感觉统合失调儿童进行恰当的心理护理，可收到事半功倍的疗效。可使儿童在愉悦宽松的氛围中进行治疗，驱除心理压力、消除心理障碍。绪论：心理护理是医用心理学的重要组成部分，也是独立的分支学科。在儿童少年精神医学领域中，儿童心理卫生占有举足轻重的地位。因此，关注儿童的心理需求，研究儿童的心理状态，是心理护理的职责之一；也是感觉统合训练中不可缺少的内容。它对改善儿童的大脑功能，促进儿童的脑发育和心理发育，起到了催化剂的作用。从而使儿童在身体、心理、社会适应和道德品质等方面得到全面、健康的发展。     

感觉统合在中枢性协调障碍中的应用

目的:探讨感觉统合训练对脑性瘫痪患儿中枢性协调障碍的影响。方法:中枢性协调障碍患儿48例为2002-01/2004-02十堰市人民医院收治,随机分为两组,对照组19例采用神经发育疗法治疗(Vojta法,Bobath法);感觉统合训练组29例,在传统神经发育疗法基础上运用感觉统合训练,根据评估结果和婴幼儿发育情况决定控制感觉输入的方案,由有经验的治疗师施行,家长同意此治疗方案并参与训练。两组均训练1次/d,30min/次,10～15d为1个疗程,要求坚持3个疗程以上。采用粗大运动功能评估量表(分5个功能区,评价1～3功能区得分,得分越高,功能越好)评估运动功能,盖塞尔发育量表评估患儿应人能、应物能、动作能、言语能各部分的发育商。结果:按意向处理分析,48例全部进入结果分析。①粗大运动功能评估量表得分:感觉统合训练组总分显著高于对照组(3865.33±1108.47,2855.79±1207.16,t=3.26,P<0.01),1～3功能区得分均高于对照组(P<0.01)。②盖塞尔发育量表评估结果:感觉统合训练组治疗后应人能、应物能、动作能、言语能得分均高于对照组(54.65±23.16,52.40±19.75;49.60±25.11,44.00±23.32;59.80±25.06,52.30±22.37;57.85±23.45;53.10±21.66,P均<0.05)。结论:在传统神经运动疗法基础上运用感觉统合训练,能有效提高粗大运动功能,尤其在改善发育商方面,可明显提高康复疗效。     

感觉统合在中枢性协调障碍中的应用

目的：探讨感觉统合训练对脑性瘫痪患儿中枢性协调障碍的影响。方法：中枢性协调障碍患儿48例为2002—01／2004—02十堰市人民医院收治，随机分为两组，对照组19例采用神经发育疗法治疗（Vojta法，Bobath法）；感觉统合训练组29例，在传统神经发育疗法基础上运用感觉统合训练，根据评估结果和婴幼儿发育情况决定控制感觉输入的方案，由有经验的治疗师施行，家长同意此治疗方案并参与训练。两组均训练1次／d，30min／次，10-15d为1个疗程，要求坚持3个疗程以上。采用粗大运动功能评估量表（分5个功能区，评价1～3功能区得分，得分越高，功能越好）评估运动功能，盖塞尔发育量表评估患儿应人能、应物能、动作能、言语能各部分的发育商。结果：按意向处理分析，48例全部进入结果分析。①粗大运动功能评估量表得分：感觉统合训练组总分显著高于对照组（3865．33&;#177;1108．47，2855．79&;#177;1207．16，t=3．26，P〈0．01），1～3功能区得分均高于对照组（P〈0．01）。②盖塞尔发育量表评估结果：感觉统合训练组治疗后应人能、应物能、动作能、言语能得分均高于对照组（54．65&;#177;23．16，5240&;#177;19．75；49．60&;#177;95．11，44．00&;#177;23．32；59．80&;#177;25．06，52．30&;#177;22．37；57．85&;#177;23．45；53．10&;#177;21．66，P均〈0．05）。结论：在传统神经运动疗法基础上运用感觉统合训练，能有效提高粗大运动功能，尤其在改善发育商方面，可明显提高康复疗效。     

感觉统合训练对高危早产儿感觉能力及运动和认知功能的影响

目的探讨感觉统合训练对高危早产儿感觉能力及运动和认知功能的影响。方法选择2016年1月至2018年6月某院收治的80例高危早产儿作为研究对象,采用随机数表法分为两组,各40例。对照组实施神经发育疗法(NDT)训练,基于此,观察组加用感觉统合训练进行干预,比较两组患儿感觉能力指数(TSFI)、认知发育指数(MDI)、精细运动发育指数(PDI)。结果干预3、6、9个月,与对照组相比,观察组TSFI指数较高,干预6、9个月,与对照组相比,观察组MDI、PDI指数均较高,差异有统计学意义(P<0.05)。结论高危早产儿采用感觉统合训练,可有效改善患儿感觉能力,利于提高患儿运动功能,对患儿的认知功能有较大改善,促进患儿恢复健康。     

Effects of sensory integration intervention on self-stimulating and self-injurious behaviors.

This study compared the effects of occupational therapy, using a sensory integration (SI) approach and a control intervention of tabletop activities, on the frequency of self-stimulating behaviors in seven children 8-19 years of age with pervasive developmental delay and mental retardation. Daily 15-min videotape segments of the subjects were recorded before, immediately after, and 1 hour after either SI or control interventions performed during alternating weeks for 4 weeks. Each 15-min video segment was evaluated by investigators to determine the frequency of self-stimulating behaviors. The results indicate that self-stimulating behaviors were significantly reduced by 11% one hour after SI intervention in comparison with the tabletop activity intervention (p = 0.02). There was no change immediately following SI or tabletop interventions. Daily ratings of self-stimulating behavior frequency by classroom teachers using a 5-point scale correlated significantly with the frequency counts taken by the investigators (r = 0.32, p < 0.001). These results suggest that the sensory integration approach is effective in reducing self-stimulating behaviors, which interfere with the ability to participate in more functional activities.     

Effects of entorhinal cortex lesions on sensory integration and spatial learning

BACKGROUND: The entorhinal cortex provides sensory information to the hippocampus for memory and learning. Damage to the entorhinal cortex is common in patients who experience traumatic brain injury, stroke, and Alzheimer's disease. Entorhinal damage is assumed to interfere with sensory integration; however, substantive knowledge of behavioral patterns is lacking. OBJECTIVES: To describe specific behavioral deficits associated with entorhinal cortex injury related to special senses identification, sensory integration, and spatial learning. METHOD: Adult male rats received bilateral entorhinal cortex damage (n = 19) or sham surgery (n = 11) with a subset randomized to participate in special senses identification, exploration, and sensory integration testing. Spatial learning was examined using a water maze. RESULTS: Lesion and control animals were similar in special senses identification testing. Sensory integration was markedly impaired in lesion animals over 3 days for all integration tasks; however, travel deficit persisted for 4 days. By day 5 sensory integration ability was equal. Lesion animals were significantly impaired across all days of spatial learning for swim time (p = .0001) and directional heading error (p = .03). Control animals exposed to sensory testing demonstrated significantly more efficient learning (p = .005) on swim days 2 and 3 versus control animals not exposed to sensory testing. CONCLUSIONS: Early and prolonged behavioral changes are evident following entorhinal cortex damage including sensory integration deficits and persistent spatial learning impairment.     

感觉性失语症患者语言治疗后错语的变化

目的：观察语言治疗对不同类型错语的影响及治疗效果,确定感觉性失语症命名困难的主要语言学层次损害。方法：对１４例感觉性失语症患者进行４周语言治疗,治疗前后对患者实施波士顿诊断性失语症检查汉语版中的图片命名测验,对测验中出现的错误分类记分;对２例患者进行单病例实验设计,观察恢复早期与后遗症期的疗效。结果：语言治疗后感觉性失语症患者的错误总量减少,急性期与恢复后期治疗后错语量减少的程度接近。结论：语言治     

语言功能训练对感觉性失语患者的影响

目的探讨相应的语言功能训练在感觉性失语患者语言康复中的应用效果。方法对90例患者随机分为实验组和对照组,各45例,两组患者药物治疗基本一致,对照组给予常规的护理,实验组在常规护理的基础上,实施相应的语言功能训练。观察两组患者的语言康复情况。结果实验组患者语言功能的恢复及认知功能较对照组明显提高,两者比较差异有统计学意义（P〈0．5）。结论相应的语言功能训练有利于感觉性失语患者语言功能的恢复。     

感觉整合模式对偏瘫患者维持平衡的作用

目的:为探讨感觉整合模式变化对平衡功能的影响,本研究测量了偏瘫患者治疗前后稳定性及平衡觉三要素的参与比例。方法:符合站立条件的偏瘫患者(54.22±8.63岁)40例,利用Pro-Kine Line 254P动静态平衡仪在训练前后分别记录平板睁眼(T1)、平板闭眼(T2)、海绵睁眼(T3)、海绵闭眼(T4)四种状态下的相关指标,分析视觉、本体觉及前庭觉的变化及对平衡的影响。结果:T1状态时,移动轨迹长(Len=202.88±52.32mm)和平均移动速度(Sv=6.76±1.75mm/s)较训练前更稳定有差异(P0.05),其他指标无差异;T2时,移动轨迹长(Len=10.45±5.66mm)较训练前更稳定有差异(P0.05),其他指标无差异;T3时,移动轨迹长(Len=430.62±159.38mm)、运动椭圆面积(Area=430.59±318.45mm2)、平均移动速度(Sv=14.35±5.31mm/s)较训练前更稳定有差异(P0.05);T4时,站立时间(time=28.07±5.08s)较训练前更长有差异(P0.05),其他指标无差异。训练前视觉、本体觉、前庭觉的参与比例为31.59%、31.39%、61.05%;训练后视觉、本体觉、前庭觉的参与比例为26.11%、34.59%、58.84%。结论:不同阶段的视觉反馈训练可以有效地提高偏瘫患者的平衡能力;训练前视觉代偿对人体维持平衡有重要作用;训练后视觉参与比例下降,本体觉参与比例上升,提示康复训练可以改变平衡感觉整合模式,改善平衡功能,因此可将本体觉与视觉参与比例变化作为监测指标,以指导偏瘫患者康复训练。     

Influence of sensory input on plantar pressure distribution

The sensory feedback control system plays a central role in human locomotion. However, few studies have been published discussing the influence of sensory input at the plantar surface of the foot on the kinematics and kinetics of locomotion. The purpose of this study was to examine the effect of changes in sensory input at the plantar surface of the foot on the pressure distribution measured at the plantar surface of the foot. Three pairs of specially made socks with sand at the plantar surface of the foot and one pair of normal socks were used to simulate different sensory inputs. Pressure distribution at the plantar surface of the foot was measured using an emed system for 10 subjects for each of the four sensory input conditions during walking and running on a treadmill. The results showed significant and substantial changes in pressure in selected areas for changes in sensory input. The pressure increased in the midfoot area and decreased in the toe area with increasing sensory inputs. These results are similar to results of a previous study where similar changes were found in a comparison between comfortable and uncomfortable shoes. RELEVANCE: Pressure distribution is increasingly used in clinical assessments. However, the factors influencing the pressure distribution pattern are only partially understood. One factor may be the sensory input into the foot. It is important to understand this influence in order to provide appropriate interpretation of the pressure distribution data.     

注意力缺陷多动症患儿感觉统合训练的效果观察

目的探讨感觉统合训练对注意力缺陷多动症儿童的治疗效果。方法由专业人员对71例注意力缺陷多动症儿童进行感觉统合训练,共2个疗程,每个疗程(20次)开始与结束时评价疗效,并比较第1、第2疗程的疗效。结果通过训练,71例患儿在运动协调、情绪稳定、完成作业、注意力、学习成绩5方面改善率为46.5%~87.3%;经比较第1、第2疗程疗效,治疗时间越长运动协调、情绪稳定、学习成绩3方面效果越显著,P均<0.05。结论感觉统合训练对注意力缺陷多动症儿童是有效的,坚持训练和掌握正确的训练方法是成功的关键。