Watemberg Nathan, Waiserberg Nilly, Zuk Luba, Lerman-Sagie Tally
Child Neurology Unit and Child Development Center, Meir Medical Center, Kfar Saba, Israel.
Dev Med Child Neurol. 2007 Dec;49(12):920-5. doi: 10.1111/j.1469-8749.2007.00920.x.
Although physical therapy (PT) is effective in improving motor function in children with developmental coordination disorder (DCD), insufficient data are available on the impact of this intervention in children with combined attention-deficit-hyperactivity disorder (ADHD) and DCD. This prospective study aimed to establish the prevalence of DCD among a cohort of patients with ADHD, characterize the motor impairment, identify additional comorbidities, and determine the role of PT intervention on these patients. DCD was detected in 55.2% of 96 consecutive children with ADHD (81 males, 15 females), mostly among patients with the inattentive type (64.3% compared with 11% of those with the hyperactive/impulsive type, p<0.05). Mean age was 8 years 4 months (SD 2 y). Individuals with both ADHD and DCD more often had specific learning disabilities (p=0.05) and expressive language deficits (p=0.03) than children with ADHD only. Twenty-eight patients with ADHD and DCD randomly received either intensive group PT (group A, mean age 9 y 3 mo, SD 2 y 3 mo) or no intervention (group B, mean age 9 y 3 mo, SD 2 y 2 mo). PT significantly improved motor performance (assessed by the Movement Assessment Battery for Children; p=0.001). In conclusion, DCD is common in children with ADHD, particularly of the inattentive type. Patients with both ADHD and DCD are more likely to exhibit specific learning disabilities and phonological (pronunciation) deficits. Intensive PT intervention has a marked impact on the motor performance of these children.
尽管物理治疗(PT)对改善发育性协调障碍(DCD)儿童的运动功能有效,但关于这种干预措施对合并注意力缺陷多动障碍(ADHD)和DCD儿童的影响的数据却很少。这项前瞻性研究旨在确定ADHD患者队列中DCD的患病率,描述运动障碍特征,识别其他合并症,并确定PT干预对这些患者的作用。在96例连续的ADHD儿童(81例男性,15例女性)中,55.2%检测出患有DCD,大多数在注意力不集中型患者中(64.3%,而多动/冲动型患者为11%,p<0.05)。平均年龄为8岁4个月(标准差2岁)。与仅患有ADHD的儿童相比,同时患有ADHD和DCD的个体更常出现特定学习障碍(p=0.05)和表达性语言缺陷(p=0.03)。28例患有ADHD和DCD的患者被随机分为接受强化小组PT治疗(A组,平均年龄9岁3个月,标准差2岁3个月)或不接受干预(B组,平均年龄9岁3个月,标准差2岁2个月)。PT显著改善了运动表现(通过儿童运动评估量表评估;p=0.001)。总之,DCD在ADHD儿童中很常见,尤其是注意力不集中型。同时患有ADHD和DCD的患者更有可能表现出特定学习障碍和语音(发音)缺陷。强化PT干预对这些儿童的运动表现有显著影响。