运动能力与儿童早期发展

儿童早期发展对个人成年时期,乃至老年阶段的全面发展和健康促进均具有重要意义,受到越来越多的社会关注。本文从早期教育中运动能力培养的角度,总结其对儿童早期体格生长、智力发展、神经心理发育的作用及对特殊儿童疾病干预的影响,为促进儿童健康成长寻找途径和方向。     

婴儿运动表现测试在昆明地区小婴儿中的应用研究

目的 通过使用婴儿运动表现测试(TIMP)对昆明地区168名婴儿进行测试,并与美国常模数据进行比较,分析影响得分的相关因素及临床应用价值,为TIMP的本土化提供一定的参考依据。 方法 对昆明地区168例足月儿及矫正胎龄 34~57⁺⁶ 周早产儿进行TIMP测试,并记录原始得分及婴儿一般情况。 结果 1)随着婴儿胎龄的增加,TIMP测试得分逐渐升高,且各组测试得分均明显低于同周龄组美国常模标准,差异有统计学意义(t＝-3.763、-4.181、-3.554、-3.423、-2.489、-3.463、-4.579、-2.612、-2.359、-3.249、-3.038、-4.248,P<0.05);2)足月儿的TIMP得分高于早产儿(t=2.615,P<0.05);出生体重≥2 500 g婴儿的TIMP得分高于出生体重在1 500~<2 500 g之间的婴儿(t=-2.593,P<0.05);测试时矫正年龄在<40周、40~44周、45~48周、49~52周、≥53周的各组婴儿间TIMP得分比较,差异有统计学意义(F=168.226,P<0.001)。3)出生时胎龄(足月或早产儿),以及进行TIMP测试时的矫正胎龄分组是TIMP得分的影响因素(β=0.164、0.743,P<0.05)。 结论 TIMP评估得分能反映不同矫正胎龄婴儿的运动表现能力,各组测试得分均明显低于同周龄组美国常模标准,因此需要建立中国常模提供本土化数据参考;并对早产儿及低出生体重儿给予早期评估和干预。     

早期被动操结合主动运动训练对早产/低体重儿体格及智能发育的影响研究

目的 分析早期被动操结合主动运动训练对早产/低体重儿体格及神经心理发育的影响,为其在早产/低体重儿体格及神经心理发育中的促进作用提供循证依据。方法 选取 2017年7月—2019年7月在金安区妇幼保健院高危儿门诊建档的218名早产/低体重儿作为研究对象,根据家长是否按照要求坚持对早产/低体重儿进行早期(校正6月龄前)被动操及主动运动训练的频率和持续时间不同进行分组,采用Gesell发育量表对研究对象进行神经心理发育评估,比较各组校正6月龄、12月龄时体格发育及Gesell评分情况。结果 早期被动操及主动运动训练频率越高及持续时间越长,早产/低体重儿在校正6月龄与12月龄时其体格测量值及智能发育商数越高,差异有统计学意义(P＜0.05)。与训练频率≤1 d/周组相比,除校正6月龄头围外,训练频率2～3 d/周组及≥4 d/周组的早产/低体重儿在校正6月龄及12月龄时体重、身长和头围测量值及适应能力、大运动、精细动作能区发育商数更高(P＜0.05);与持续时间0～2个月组相比,持续时间5～6个月组的早产/低体重儿在校正6月龄及12月龄时体重、身长及适应能力、精细动作、社交行为等能区发育商数更高(P＜0.05)。结论 家长坚持给予早产/低体重儿做被动操及主动运动训练对其体格和神经心理发育具有一定的促进作用。     

成年起病脊肌萎缩症SMN基因外显子7缺失的初探

目的探讨成年起病的脊肌萎缩症(SMA)患者的运动神经元存活基因SMN的缺失情况。方法用聚合酶链反应-酶切技术对15例SMA病人及33例正常对照的外显子7进行检测,明确有无缺失。结果3例SMA的SMN基因外显子7纯合缺失,其余12例和对照组均阴性。结论SMN基因外显子7缺失可作为成年起病SMA的辅助诊断,以提示SMA遗传的异质性。     

褪黑素对大鼠体温及活动度昼夜节律的影响

目的　了解外源性褪黑素对大鼠体温及活动度昼夜节律的影响及其可能的调节机制。方法　正常光照条件下,24h连续记录大鼠的体温及活动度的变化,以不同剂量褪黑素在不同的昼夜时间给药观察体温和活动度节律的变化。结果　大鼠的体温及活动度存在昼夜节律性,给药后昼夜节律性不消失;但体温振幅减小,中值降低。黑暗中期给药后,峰值位相显著延迟;活动度振幅增加,中值显著降低,峰值位相延迟。结论　外源性褪黑素不能使体温或活动度的昼夜节律消失,而只是改变昼夜节律的参数。褪黑素可分别调节体温和活动度的昼夜节律,但对活动度的调节作用更为明显。     

Decreased neuroplasticity in minor burn injury survivors compared to non-injured adults: A pilot study in burn injury survivors aged 45 years and older

ObjectiveNeuroplasticity is the capacity of the brain to change or adapt with experience: brain changes occur with use, disuse, and injury. Repetitive transcranial magnetic stimulation (rTMS) can be used to induce neuroplasticity in the human brain. Here, we examined rTMS-induced neuroplasticity in the primary motor cortex in burns survivors and controls without injury, and whether neuroplasticity is associated with functional recovery in burns survivors.MethodsSixteen burn injury survivors (total body surface area of burn injury <15%) and 13 non-injured control participants were tested. Repetitive TMS (specifically, spaced continuous theta-burst stimulation[cTBS]) was applied to induce neuroplasticity 6 and 12 weeks after injury in burn survivors and in two sessions separated by 6 weeks in controls. Motor evoked potentials (MEPs) elicited by single-pulse TMS were measured before and after rTMS to measure neuroplasticity. Burns survivors completed a functional assessment 12 weeks after injury.ResultsNon-injured controls showed decreased MEP amplitude 15?30 min after spaced cTBS in both experimental sessions. Burn survivors showed a smaller change in MEP amplitude after spaced cTBS compared to controls 6 weeks after burn injury but no difference compared to controls 12 weeks after burn injury. In burn survivors, there was a significant positive association between general health outcome (Short-Form Health Survey) and the change in MEP amplitude after spaced cTBS 12 weeks after injury (r=.73, p = .01).ConclusionsThe current findings suggest that burn survivors have a reduced capacity for neuroplasticity early in the recovery period (6 weeks after injury), which normalizes later in the recovery period (12 weeks after injury). Furthermore, the results provide preliminary evidence to suggest that burn survivors with normalized neuroplasticity 12 weeks after injury recover faster after burn injury.     

Comparison of Single and Dual Monitoring during Carotid Endarterectomy

We compared the rate of selective shunt and pattern of monitoring change between single and dual monitoring in patients undergoing carotid endarterectomy (CEA). A total of 121 patients underwent 128 consecutive CEA procedures. Excluding five procedures using internal shunts in a premeditated manner, we classified patients according to the monitoring: Group A (n = 72), patients with single somatosensory evoked potential (SSEP) monitoring; and Group B (n = 51), patients with dual SSEP and motor evoked potential (MEP). Among the 123 CEAs, an internal shunt was inserted in 12 procedures (9.8%) due to significant changes in monitoring (Group A 5.6%, Group B 15.7%, p = 0.07). The rate of shunt use was significantly higher in patients with the absence of contralateral proximal anterior cerebral artery (A1) on magnetic resonance angiography (MRA) than in patients with other types of MRA (p <0.001). Significant monitor changes were seen in 16 (12.5%) in both groups. In four of nine patients in Group B, SSEP and MEP changes were synchronized, and in the remaining five patients, a time lag was evident between SSEP and MEP changes. In conclusion, the rate of internal shunt use tended to be more frequent in patients with dual monitoring than in patients with single SSEP monitoring, but the difference was not significant. Contralateral A1 absence may predict the need for a shunt and care should be taken to monitor changes throughout the entire CEA procedure. Use of dual monitoring can capture ischemic changes due to the complementary relationship, and may reduce the rate of false-negative monitor changes during CEA.     

Corticostriatal projections from the somatic motor areas of the frontal cortex in the macaque monkey: segregation versus overlap of input zones from the primary motor cortex, the supplementary motor area, and the premotor cortex

It is an important issue to address the mode of information processing in the somatic motor circuit linking the frontal cortex and the basal ganglia. In the present study, we investigated the extent to which corticostriatal input zones from the primary motor cortex (MI), the supplementary motor area (SMA), and the premotor cortex (PM) of the macaque monkey might overlap in the putamen. Intracortical microstimulation was performed to map the MI, SMA, and dorsal (PMd) and ventral (PMv) divisions of the PM. Then, two different anterograde tracers were injected separately into somatotopically corresponding regions of two given areas of the MI, SMA, PMd, and PMv. With respect to the PMd and PMv, tracer injections were centered on their forelimb representations. Corticostriatal input zones from hindlimb, forelimb, and orofacial representations of the MI and SMA were, in this order, arranged from dorsal to ventral within the putamen. Dense input zones from the MI were located predominantly in the lateral aspect of the putamen, whereas those from the SMA were in the medial aspect of the putamen. On the other hand, corticostriatal inputs from forelimb representations of the PMd and PMv were distributed mainly in the dorsomedial sector of the putamen. Thus, the corticostriatal input zones from the MI and SMA were considerably segregated though partly overlapped in the mediolateral central aspect of the putamen, while the corticostriatal input zone from the PM largely overlapped that from the SMA, but not from the MI. Received: 30 June 1997 / Accepted: 2 October 1997