痉挛型脑瘫儿童的发育特征和气质模式：与亚型和严重程度的关系。

Developmental profiles and temperament patterns in children with spastic cerebral palsy: relationships with subtypes and severity.

机构信息

Graduate Institute of Early Intervention, Department of Physical Therapy, Chang Gung University, Taoyuan, Taiwan.

出版信息

J Formos Med Assoc. 2011 Aug;110(8):527-36. doi: 10.1016/S0929-6646(11)60079-X.

Abstract

BACKGROUND/PURPOSE: Elucidating developmental profiles and temperament patterns in children with cerebral palsy (CP) could help clinicians elaborate more flexible strategies for treating these children. This study investigated the developmental profiles and temperament patterns in children with spastic CP (sCP) of different subtypes and severities.

METHODS

One hundred and five children, aged 3-6 years, with sCP and 66 children with typical development (TD) were analyzed. Children with sCP were classified into spastic diplegia (SD; n = 60), and spastic quadriplegia (SQ; n = 45) groups. Motor severity was classified via the Gross Motor Function Classification System (GMFCS). Development quotients (DQs) of eight domains and temperament scores of nine dimensions were evaluated.

RESULTS

The SQ group had lower DQs in all developmental functions than the SD group (p < 0.01). The DQ distributions of developmental profiles showed the same trend in SD and SQ groups, and both groups displayed lowest DQs in the gross motor domain. The SQ group was less adaptable and approachable than the TD group (p < 0.05), and both sCP groups had lower attention span and persistence and a higher threshold of responsiveness than the TD group (p < 0.05). Correlation analysis showed that GMFCS levels were highly related to all developmental functions (r < -0.54, p<0.01) and weakly related to some temperament dimensions in children with sCP.

CONCLUSION

The subtype and severity of sCP were associated with developmental profiles in children with sCP Temperament patterns were different between SD and SQ groups, but only weakly related to motor deficit. These data could allow clinicians to anticipate the developmental profiles and temperament patterns and plan appropriate therapeutic strategies for children with sCP.

摘要

背景/目的：阐明脑瘫（CP）患儿的发育特征和气质模式，有助于临床医生为这些儿童制定更灵活的治疗策略。本研究调查了不同亚型和严重程度痉挛型脑瘫（sCP）患儿的发育特征和气质模式。

方法

分析了 105 名 3-6 岁 sCP 患儿和 66 名典型发育（TD）儿童。sCP 患儿分为痉挛性双瘫（SD；n=60）和痉挛性四肢瘫（SQ；n=45）组。采用粗大运动功能分类系统（GMFCS）对运动严重程度进行分类。评估了八个领域的发育商（DQ）和九个维度的气质评分。

结果

与 SD 组相比，SQ 组所有发育功能的 DQ 均较低（p<0.01）。SD 和 SQ 组的发育特征 DQ 分布呈相同趋势，两组均在粗大运动领域的 DQ 最低。与 TD 组相比，SQ 组适应性和可接近性较差（p<0.05），两组 sCP 患儿的注意力持续时间、坚持性和反应阈值均低于 TD 组（p<0.05）。相关性分析表明，GMFCS 水平与 sCP 患儿的所有发育功能高度相关（r<-0.54，p<0.01），与某些气质维度弱相关。