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注意缺陷多动障碍儿童的运动能力和适应功能。

Motor ability and adaptive function in children with attention deficit hyperactivity disorder.

机构信息

Department of Physical Therapy, College of Health Science, Kaohsiung Medical University, Taiwan.

出版信息

Kaohsiung J Med Sci. 2011 Oct;27(10):446-52. doi: 10.1016/j.kjms.2011.06.004. Epub 2011 Jul 23.

Abstract

Attention deficit hyperactivity disorder (ADHD) is a common neuropsychiatric disorder. Previous studies have reported that children with ADHD exhibit deficits of adaptive function and insufficient motor ability. The objective of this study was to investigate the association between adaptive function and motor ability in children with ADHD compared with a group of normal children. The study group included 25 children with ADHD (19 boys and 6 girls), aged from 4.6 years to 8.6 years (mean±standard deviation, 6.5±1.2). A group of 24 children without ADHD (normal children) were selected to match the children with ADHD on age and gender. The Movement Assessment Battery for Children, which includes three subtests, was used to assess the motor ability of the children of both groups. The Chinese version of Adaptive Behavior Scales, which consists of 12 life domains, was used to assess adaptive function of the children with ADHD. Compared with the normal children, children with ADHD exhibited poorer motor ability on all the three subtests of motor assessment. In the ADHD group, nine (36%) children had significant motor impairments and seven (28%) were borderline cases. A total of 10 (40%) children with ADHD had definite adaptive problems in one or more adaptive domains. With statistically controlling of IQ for the ADHD group, those children with impaired motor ability had significantly poorer behaviors in the adaptive domain of home living (p=0.035). Moreover, children with ADHD who had severely impaired manual dexterity performed worse than the control group in the adaptive domains of home living (r=-0.47, p=0.018), socialization (r=-0.49, p=0.013), and self-direction (r=-0.41, p=0.040). In addition, children with poorer ball skills had worse home living behavior (r=-0.56, p=0.003). Children who had more impaired balance exhibited poorer performance in social behavior (r=-0.41, p=0.040). This study found significant correlation between motor ability and adaptive function in children with ADHD, especially in their adaptive domains of home living, socialization, and self-direction. In clinical settings, identification of motor difficulties may have important implications for the understanding of relative factors in effective management of the adaptive dysfunction in children with ADHD.

摘要

注意缺陷多动障碍(ADHD)是一种常见的神经精神疾病。先前的研究报告称,ADHD 患儿表现出适应功能缺陷和运动能力不足。本研究旨在探讨 ADHD 患儿与正常儿童相比,其适应功能与运动能力之间的关系。研究组包括 25 名 ADHD 患儿(男 19 名,女 6 名),年龄 4.6 至 8.6 岁(平均±标准差,6.5±1.2)。选择了 24 名无 ADHD 的儿童(正常儿童)与 ADHD 患儿进行年龄和性别匹配。采用儿童运动评估成套测验(Movement Assessment Battery for Children,MABC)的三个分量表评估两组儿童的运动能力。采用包含 12 个生活领域的适应行为量表(Adaptive Behavior Scales,中文版)评估 ADHD 患儿的适应功能。与正常儿童相比,ADHD 患儿在运动评估的所有三个分量表上均表现出较差的运动能力。在 ADHD 组中,9 名(36%)儿童存在明显的运动障碍,7 名(28%)儿童为边缘病例。共有 10 名(40%)ADHD 患儿在一个或多个适应领域存在明确的适应问题。在 ADHD 组中,在控制智商后,那些运动能力受损的儿童在家庭生活的适应领域表现出明显较差的行为(p=0.035)。此外,在家庭生活、社会交往和自我指导等适应领域中,手部灵活性严重受损的 ADHD 患儿的表现明显低于对照组(r=-0.47,p=0.018);球技较差的儿童在家庭生活行为方面表现较差(r=-0.56,p=0.003);平衡能力较差的儿童在社会行为方面表现较差(r=-0.41,p=0.040)。综上所述,本研究发现 ADHD 患儿的运动能力与适应功能之间存在显著相关性,尤其是在家庭生活、社会交往和自我指导等适应领域。在临床实践中,识别运动困难可能对理解 ADHD 患儿适应功能障碍的相关因素以及有效管理具有重要意义。

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