注意缺陷多动障碍儿童与正常儿童平衡功能发育特点比较

目的:探讨注意缺陷多动障碍(ADHD)男孩以及对照儿童的平衡功能发育特点.方法:采用美国NeuroCom公司的平衡仪,以146例符合ADHD诊断的男孩及84名正常对照男孩(年龄在7～12岁)为研究研究对象,测试其静态平衡功能.结果:(1)正常男孩:发现在固定平面闭眼和海绵垫平面闭眼状态下存在组间差异,差异具有统计学意义.在固定平面睁眼条件下各相邻年龄组间差异无统计学意义,但11～12岁组仍差于成人水平,差异有统计学意义(t=6.145,P＜0.001);在固定平面闭眼和海绵垫平面睁眼状态下7～8岁组与9～10岁组,差异具有统计学意义固定平面闭眼7～8岁组为(0.65±0.35)°/s,9～10岁组为(0.45±0.19)°/s,P＜0.05 ;海绵垫平面睁眼7～8岁组为(0.98±0.38)°/s ,9～10岁组为(0.80±0.25)°/s, P＜0.05];11～12岁组仍差于成人水平,差异有统计学意义((t值分别为5.059,6.203,P＜0.001);在海绵垫平面闭眼状态下7～8岁组与9～10岁组,差异具有统计学意义7～8岁组为(1.65±0.58)°/s,9～10岁组为(1.34±0.42)°/s,P＜0.05].11～12岁组与成人比较差异无统计学意义.(2)ADHD男孩:在四种测试状态下7～8岁组与9～10岁组差异具有统计学意义固定平面睁眼7～8岁组为(0.81±0.31)°/s,9～10岁组为(0.63±0.28)°/s,P＜0.01;固定平面闭眼7～8岁组为(0.91±0.46)°/s,9～10岁组为(0.70±0.49)°/s,P＜0.05;海绵垫平面睁眼7～8岁组为(1.31±0.56)°/s,9～10岁组为(1.10±0.43)°/s,P＜0.05;海绵垫平面闭眼7-8岁组为(2.19±0.88)°/s,9～10岁组为(1.85±0.78)°/s,P＜0.05],9～10岁组与11～12岁组,差异具有统计学意义固定平面睁眼9～10岁组为(0.63±0.28)°/s,11～12岁组为(0.46±0.21)°/s,P＜0.01;固定平面闭眼9～10岁组为(0.70±0.49)°/s,11～12岁组为(0.47±0.31)°/s,P＜0.01;海绵垫平面睁眼9～10岁组为(1.10±0.43)°/s,11～12岁组为(0.83±0.27)°/s,P＜0.001;海绵垫平面闭眼9～10岁组为(1.85±0.78)°/s,11～12岁组为(1.44±0.56)°/s,P＜0.01].(3)ADHD男孩与正常男孩不同年龄阶段姿势发育比较: 在7-8岁组在固定平面睁眼状态下ADHD男孩平均摇摆速率大于正常儿童,差异具有统计学意义(t=2.700, P＜0.05), 9～10岁组在四种测试条件下ADHD男孩平均摇摆速率均大于正常儿童,差异具有统计学意义(四种状态下t值分别为2.968,2.982,3.851,3.629,四种状态下P＜0.05).结论:平衡功能在儿童学龄阶段仍在发展,11～12岁时尚未达到成人水平.ADHD男孩平衡功能随年龄增长而发展但落后于正常男孩,在青春期前发展快.

Comparison of postural control between normal and attention deficit hyperactivity disorder boys

OBJECTIVE: To examine postural control between normal and attention deficit hyperactivity disorder (ADHD) boys, and compare the development characters. METHODS: In the study, 146 ADHD boys and 84 normal boys participated, ages being between 7 and 12 years. Balance Master was used to assess posture control. Posture stabilities were tested under 4 different conditions (firm surface with eyes open, firm surface with eyes closed, foam pad with eyes open, foam pad with eyes closed). We tested three times for one condition, 20 s per time. The mean sway velocity was recorded. RESULTS: (1) Normal boys: In firm surface with eyes open, analyses of variance between normal boys revealed no significant differences between different age groups, and the 11- and 12-year-old group did not achieve scores comparable to the adult (t=6.145, P<0.001). In firm surface with eyes closed and, foam pad with eyes open analyses revealed significant differences between the 7- and 8-year-old and 9- and 10-year-old groupsfirm surface with eyes closed, 7- and 8-year-old (0.65+/-0.35) degrees/s, 9- and 10-year-old (0.45+/-0.19) degrees/s, P<0.05; foam pad with eyes open, 7- and 8-year-old (0.98+/-0.38) degrees/s, 9- and 10-year-old (0.80+/-0.25) degrees/s, P<0.05] and the 11- and 12-year-old group did not achieve scores comparable to the adult (t=5.059, 6.206, P<0.001). In foam pad with eyes closed, analyses revealed significant differences between 7- and 8-year-old and 9- and 10-year-old groups 7- and 8-year-old (1.65+/-0.58) degrees /s,9- and 10-year-old (1.34+/-0.42) degrees/s, P<0.05], the 11- and 12-year-old group achieving scores comparable to the adult. (2) ADHD boys: Analyses of variance between ADHD boys, under the four different conditions, revealed significant differences between 7- and 8-year-old and 9- and 10-year-old firm surface with eyes open, 7- and 8-year-old (0.81+/-0.31) degrees/s, 9- and 10-year-old (0.63+/-0.28) degrees/s, P<0.01; firm surface with eyes close, 7- and 8-year-old (0.91+/-0.46) degrees/s, 9- and 10-year-old (0.70+/-0.49) degrees/s, P<0.05; foam pad with eyes open, 7- and 8-year-old (1.31+/-0.56) degrees/s, 9- and 10-year-old (1.10+/-0.43) degrees/s, P<0.05; foam pad with eyes close, 7- and 8-year-old (2.19+/-0.88) degrees/s, 9- and 10-year-old (1.85+/-0.78) degrees/s, P<0.05], and also significant differences between 9- and 10-year-old and 11- and 12-year-old groupsfirm surface with eyes open, 9- and 10-year-old (0.63+/-0.28) degrees/s,11- and 12-year-old (0.46+/-0.21) degrees/s, P<0.01; firm surface with eyes close, 9- and 10-year-old (0.70+/-0.49) degrees/s, 11- and 12-year-old (0.47+/-0.31) degrees/s, P<0.01; foam pad with eyes open, 9- and 10-year-old (1.10+/-0.43) degrees/s, 11- and 12-year-old (0.83+/-0.27) degrees/s, P<0.001; foam pad with eyes close, 9- and 10-year-old (1.85+/-0.78) degrees/s, 11- and 12-year-old (1.44+/-0.56) degrees/s, P<0.01]. (3) Comparison of postural control between normal and ADHD boys: In firm surface with eyes open, analyses revealed the 7- and 8-year-old group swayed higher in ADHD group than in normal control(t=2.700, P<0.05), in the other three conditions there was a significant tendency. In the four conditions, the 9- and 10-year-old group swayed higher in ADHD group than in normal control (t=2.968,2.982, 3.851,3.629, P<0.05). CONCLUSION: These results suggest that children do not demonstrate adult-like use of sensory information at the ages of 11 and 12 years. ADHD boys have a lower posture control ability than normal boys.