目的 对学龄前痉挛型脑瘫(SCP)儿童的视觉运动整合(VMI)能力进行评估并分析其相关因素,为SCP患儿的早期干预提供参考。方法 选取2022年12月—2023年6月在云南省残疾人康复中心就诊的51例SCP患儿和同期就读于昆明医科大学幼儿园的74例正常儿童纳入研究。所有儿童均完成Beery-Buktenica视觉运动整合发育测试(Beery VMI)、视知觉(VP)测试及运动协调性(MC)测试,通过调查问卷收集人口学特征数据,分析SCP儿童VMI的相关性因素。结果 正常儿童不同年龄组间Beery VMI、VP及MC测试结果,差异有统计学意义(F=65.458、23.526、45.270,P<0.001),SCP儿童不同年龄组间比较,差异无统计学意义(P>0.05)。与正常儿童相比,除3～岁年龄组外,其他年龄组SCP儿童VMI原始分均落后于正常儿童,差异有统计学意义(t=3.033、4.933、6.014,P<0.05)。SCP儿童VMI与粗大运动功能分级呈负相关(rs=-0.376, P=0.007),与VP和MC均呈强正相关(r=0.618,rs=0.743,P<0.001)。结论 学龄前SCP儿童的VMI、VP和MC能力显著落后于正常儿童,提示这三个功能是其常见障碍,可考虑纳入常规评估流程。学龄前SCP儿童的VMI与粗大运动功能分级、VP和MC具有相关性,为改善VMI的康复治疗提供了参考信息。
Abstract
Objective To assess the visual motor integration(VMI) in preschool children with spastic cerebral palsy(SCP), and to analyze the associated factors, so as to provide reference for the early intervention of SCP. Methods A total of 51 children with SCP who received treatment at the Yunnan Rehabilitation Center from December 2022 to June 2023 and 74 typically developed children attending the Kunming Medical University Kindergarten during the same period were included in the study. All children completed the Beery-Buktenica Developmental Test of VMI(Beery VMI), visual perception(VP) test, and motor coordination(MC) test. Demographic characteristics were collected through a survey questionnaire, and the factors related to VMI in children with SCP were analyzed. Results There were significant differences in Beery VMI, VP, and MC tests scores in typically developed children among different age groups(F=65.458, 23.526, 45.270, P<0.001), there were no significant differences in children with SCP among different age groups(P>0.05). Compared to typically developed children, except for the 3-year-old age group, the raw scores of VMI in SCP children in other age groups were significantly lower than those of typically developed children(t=3.033, 4.933, 6.014, P<0.05). VMI score in children with SCP was negatively related to Gross Motor Function Classification System(GMFCS) score(rs=-0.736, P=0.007), and showed strongly positive correlations with VP and MC(r=0.618, rs=0.743, P<0.001). Conclusions The VMI, VM, MC of preschool children with SCP are significantly behind those of normal children, suggesting that these three functions are common disabilities and could be considered for inclusion in routine assessment procedures. The VMI of preschool children with SCP is correlated with GMFCS, VP, and MC, providing reference for improving VMI in rehabilitation treatment.
关键词
学龄前痉挛型脑瘫 /
视觉运动整合 /
视知觉
Key words
spastic cerebral palsy of preschoolers /
visual motor integration /
visual perception
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参考文献
[1] Carsone B, Green K, Torrence W, et al. Systematic review of visual motor integration in children with developmental disabilities[J]. Occup Ther Int, 2021, 2021: 1801196.
[2] Steinhart S, Weiss PL, Friedman J. Proximal and distal movement patterns during a graphomotor task in typically developing children and children with handwriting problems[J]. J Neuroeng Rehabil, 2021, 18(1): 178.
[3] Carames CN, Irwin LN, Kofler MJ. Is there a relation between visual motor integration and academic achievement in school-aged children with and without ADHD?[J].Child Neuropsychol, 2022, 28(2): 224-243.
[4] 姬卫华,高宏华,王娟,等.痉挛型脑性瘫痪儿童视觉运动整合障碍的特征研究[J]. 中国康复医学杂志,2023,38(8):1073-1078.
Ji WH, Gao HH, Wang J. et al. Characteristics of visual motor integration ability in children with spastic cerebral palsy[J].Chin J of Rehab Med,2023,38(8):1073-1078.(in Chinese)
[5] Tebani A, Marret S. Early intervention in cerebral palsy and beyond[J]. JAMA Pediatr, 2021, 175(8): 785-787.
[6] Duke RE, Nwachukuw J, Torty C, et al. Visual impairment and perceptual visual disorders in children with cerebral palsy in Nigeria[J]. Br J Ophthalmol, 2022, 106(3): 427-434.
[7] Novak I, Morgan C, Adde L, et al. Early, accurate diagnosis and early intervention in cerebral palsy: Advances in diagnosis and treatment[J]. JAMA Pediatr, 2017, 171(9): 897-907.
[8] Asem M, Narayanasamy S, Ahmad M, et al. Association between visual perception and socioeconomic status in malaysian preschool children: Results from the Test of Visual Perceptual Skills-4[J]. Children(Basel), 2023, 10(4):749.
[9] Lim CY, Tan PC, Koh C, et al. Beery-Buktenica Developmental Test of Visual-Motor Integration(Beery-VMI): Lessons from exploration of cultural variations in visual-motor integration performance of preschoolers[J]. Child Care Health Dev, 2015, 41(2): 213-221.
[10] 唐久来,秦炯,邹丽萍,等.中国脑性瘫痪康复指南(2015):第一部分[J].中国康复医学杂志,2015,30(7): 747-754.
Tang JL,Qin J, Zou LP, et al, Rehabilitation guideline for cerebral palsy(2015):Part one[J]. Chin J of Rehab Med, 2015, 30(7): 747-754.(in Chinese)
[11] 卞秋翔,王军.丹佛智能发育筛查结合神经运动功能评估技术在婴儿脑发育问题临床诊疗中的应用价值[J].中国妇幼保健,2019,34(15):3606-3610.
Bian QX, Wang J. Clinical value of Denver Developmental Screen Combination with Neurological Motor Assessments in infant with brain developmental disorders[J].Mental and Child Health Care of China,2019, 34(15): 3606-3610.(in Chinese)
[12] Preda C. Test of visual-motor integration: Construct validity in a comparison with the Beery-Buktenica Developmental Test of Visual-Motor Integration[J]. Percept Mot Skills, 1997, 84(3 Pt 2): 1439-1443.
[13] Harvey EM, Leonard-Green TK, Mohan KM, et al. Interrater and Test-Retest Reliability of the Beery Visual-Motor Integration in Schoolchildren[J]. Optom Vis Sci, 2017, 94(5): 598-605.
[14] Ng M, Chui M, Lin L, et al. Performance of the visual-motor integration of preschool children in Hong Kong[J].Hong Kong Journal of Occupational Therapy, 2015, 25: 7-14.
[15] 徐蕖,区嘉欣,张青宇,等.南京市学龄前儿童视觉运动整合发育测验评估及相关因素分析[J].中国儿童保健杂志,2019,27(4):355-357.
Xu Q, Ou JX, Zhang QY,et al. Assessment of Visual Motor Integration and association factors of Preschooler in Nanjing[J].Chin J Child Health Care, 2019, 27(4): 355-357.(in Chinese)
[16] Vancleef K, Janssens E, Petré Y, et al. Assessment tool for visual perception deficits in cerebral visual impairment: Reliability and validity[J]. Dev Med Child Neurol, 2020, 62(1): 118-124.
[17] Alwhaibi RM, Alsakhawi RS, Elkholi SM. Augmented biofeedback training with physical therapy improves visual-motor integration, visual perception, and motor coordination in children with spastic hemiplegic cerebral palsy:A randomised control trial[J]. Phys Occup Ther Pediatr, 2020, 40(2): 134-151.
[18] Hairol MI, Nordin N, P'ng J, et al. Association between reduced visual-motor integration performance and socioeconomic factors among preschool children in Malaysia: A cross-sectional study[J]. PLoS One, 2021, 16(3): e0246846.
[19] Flatters I, Mushtaq F, Hill LJ, et al. The relationship between a child's postural stability and manual dexterity[J]. Exp Brain Res, 2014, 232(9): 2907-2917.
[20] Piscitelli D, Ferrarello F, Ugolini A, et al. Measurement properties of the Gross Motor Function Classification System, Gross Motor Function Classification System-Expanded & Revised, Manual Ability Classification System, and Communication Function Classification System in cerebral palsy: A systematic review with meta-analysis[J]. Dev Med Child Neurol, 2021, 63(11): 1251-1261.
基金
昆明医科大学2023年研究生创新基金(2023B006);云南省科技厅-昆明医科大学基础研究联合专项面上项目(202401AY070001-204)
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