目的 探讨家庭干预的投入程度与0～3岁高危儿运动功能干预效果的关系,以期为高危儿早期干预策略提供思路。方法 将2020年6月—2022年4月江苏省妇幼保健院儿童保健科收治的81例运动发育迟缓高危儿纳入研究进行随访。所有患儿定期进行医院干预,同时予以家庭指导,根据平均每日家庭参与干预时长将患儿分为<15min/d组和≥15min/d组。分别于干预前及干预3个月后采用Peabody运动发育量表评估患儿的运动功能水平,比较干预效果。结果 全部患儿干预后粗大运动发育商(GMQ)、精细运动发育商(FMQ)、总体运动发育商(TMQ)均高于干预前,差异均有统计学意义(t=5.250、5.601、5.705,P<0.05);进一步分组比较,开始干预年龄段为0~12月龄与13~36月龄的患儿在<15min/d组和≥15min/d组中,干预后GMQ、FMQ、TMQ较干预前均提高,差异均有统计学意义(P<0.05);<15min/d组中和≥15min/d组中,0~12月龄患儿干预后GMQ、FMQ、TMQ较13~36月龄患儿均提高得更多,差异有统计学意义(P<0.05);头颅MRI异常患儿的家庭比无异常患儿的家庭更容易每日投入较多干预时间(χ2=4.516,P=0.034),干预后GMQ、FMQ、TMQ提高得也更多,差异均有统计学意义(t=2.104、2.264、2.757,P<0.05)。结论 医院康复干预结合家庭干预的早期干预训练模式对提高0~3岁运动发育迟缓高危儿的运动功能有较好的促进作用,投入程度较高以及尽早开始投入的家庭干预能更好地改善患儿运动发育水平。患儿头颅MRI结果对家庭干预的积极性及干预效果有一定程度的影响。
Abstract
Objective To explore the relationship between the involvement degree of family intervention and the effect of motor function intervention on high-risk infants aged 0 to 3 years, in order to provide ideas for early intervention strategies for high-risk infants. Methods From June 2020 to April 2022, 81 high-risk infants with motor development retardation were included in this study for follow-up. All children received regular intervention in hospital and family guidance, and were divided into group with intervention frequency of <15min/d and group with intervention frequency of ≥15min/d according to the average length of daily family intervention. The level of children′s motor function was evaluated with Peabody Developmental Motor Scale (PDMS-2) before and 3 months after the intervention, and the intervention effect was compared. Results After intervention, gross motor development quotient (GMQ), fine motor development quotient (FMQ) and total motor development quotient (TMQ) of all children were significantly higher than those before intervention (t=5.250, 5.601, 5.705, P<0.05). Further group comparison showed that the GMQ, FMQ and TMQ both in children aged 0 - 12 months and 13 - 36 months were significantly higher than those before intervention in group with intervention frequency of <15min/d and group with intervention frequency of ≥15min/d (P<0.05), but the GMQ, FMQ and TMQ of children aged 0 - 12 months after intervention were significantly higher than those of children aged 13 - 36 months (P<0.05). Families of children with abnormal cranial MRI were more likely to devote more time to the intervention each day than families of children without abnormalities (χ2=4.516, P=0.034), and GMQ, FMQ and TMQ all improved significantly more in families of children with abnormal cranial MRI after the intervention (t=2.104,2.264,2.757,P<0.05). Conclusions The early intervention training mode of hospital rehabilitation intervention combined with family intervention has a good promotion effect on improving the motor function of high-risk children with motor retardation aged 0 - 3 years. Family interventions that involve a higher level of investment and an early start are more likely to improve children′s motor development. The findings of the child′s cranial MRI have a certain influence on the family motivation and the effectiveness of the intervention.
关键词
高危儿 /
早期干预 /
家庭干预 /
运动发育迟缓
Key words
high-risk children /
early intervention /
family intervention /
delayed motor development
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