Kramer J F, Ashton B, Brander R
Department of Physical Therapy, Faculty of Applied Health Sciences, University of Western Ontario, London, Canada.
Child Care Health Dev. 1992 Nov-Dec;18(6):365-76. doi: 10.1111/j.1365-2214.1992.tb00366.x.
The purpose of this study was to compare the semi-prone (SP) and sitting (SIT) training positions with respect to head control in children with cerebral palsy, before and after 5 weeks biofeedback training using a head position trainer (HPT). Four children were randomly assigned to each of two training groups: (a) SP on a prone board inclined 45 degrees above the horizontal and (b) SIT in their personal wheelchair and orthotic device. The HPT, secured to the child's head, controlled a video-cassette player, turning it off when the head deviated beyond 25 degrees from the vertical (termed an error). The time in error and the number of errors during test periods of 3 minutes, without feedback and completed in both the SP and the SIT positions, were determined immediately before and after, and at 16 weeks after training. The SIT trained group performed significantly better immediately post-training in three of four comparisons (P < 0.01), but the groups performed similarly in the other eight comparisons--four immediately pre-training and four at 16 weeks post-training (P > 0.05). Post-training scores for the total group (n = 8) were significantly improved over pre-training scores, regardless of the test position or the criterion measurement (P < 0.05). Biofeedback training with a HPT can be effective in either the SIT or the SP positions, with improvement lasting at least 16 weeks after training is discontinued.
本研究的目的是比较在使用头部位置训练器（HPT）进行5周生物反馈训练前后，脑瘫儿童在半俯卧（SP）和坐姿（SIT）训练姿势下的头部控制情况。将4名儿童随机分配到两个训练组中的每一组：（a）在与水平方向成45度角倾斜的俯卧板上半俯卧，以及（b）在其个人轮椅和矫形装置中坐姿。固定在儿童头部的HPT控制一台盒式录像机，当头部偏离垂直方向超过25度（称为误差）时将其关闭。在无反馈的3分钟测试期内，分别在训练前、训练后以及训练后16周，测定在SP和SIT姿势下的误差时间和误差次数。接受SIT训练的组在训练后立即进行的四项比较中有三项表现明显更好（P < 0.01），但在其他八项比较中两组表现相似——四项在训练前立即进行，四项在训练后16周进行（P > 0.05）。无论测试姿势或标准测量如何，整个组（n = 8）的训练后分数均显著高于训练前分数（P < 0.05）。使用HPT进行生物反馈训练在SIT或SP姿势下均有效，训练停止后改善效果至少持续16周。
