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脑性瘫痪儿童粗大运动与智力功能的关系:一项横断面研究。

Relationship between gross motor and intellectual function in children with cerebral palsy: a cross-sectional study.

机构信息

Department of Occupational Therapy, Faculty of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Arch Phys Med Rehabil. 2012 Mar;93(3):480-4. doi: 10.1016/j.apmr.2011.10.019. Epub 2012 Jan 21.

Abstract

OBJECTIVE

To explore the relationship between gross motor and intellectual function in children with cerebral palsy (CP).

DESIGN

A cross-sectional study.

SETTING

Occupational therapy clinic.

PARTICIPANTS

Children with CP (N=662; 281 girls, 381 boys; age range, 3-14y).

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Intelligence testing was carried out by means of the Wechsler Preschool and Primary Scale of Intelligence and the Wechsler Intelligence Scale for Children-Revised. Gross motor function level was determined by the Gross Motor Function Classification System Expanded and Revised (GMFCS E&R).

RESULTS

Of the children, 10.4% were at level I of the GMFCS E&R, 38% at levels II and III, and 51.5% at levels IV and V. The lowest level of intelligence or profound intellectual disability was found in children with spastic quadriplegia (n=28, 62.2%). Children at the lowest levels (I-IV, GMFCS E&R) obtained higher ratings in terms of intelligence in comparison with children at level V. Based on the present results, the diagnosis was statistically related to the intellectual level as dependent variable (P<.01); accordingly, hypotonic, quadriplegic, and hemiplegic patients had the highest odds to assign higher ratings in abnormal intelligence, respectively. Sex and age were not statistically related to the dependent variable.

CONCLUSIONS

The study results demonstrated a significant association between GMFCS E&R and intellectual function. Therefore, we suggest that particular attention should be paid to the intellectual level in terms of evaluations of gross motor function. These results, in respect, might be interested for occupational and physical therapists who are involved in rehabilitation programs for these children.

摘要

目的

探讨脑瘫(CP)儿童粗大运动与智力功能的关系。

设计

横断面研究。

地点

职业治疗诊所。

参与者

CP 患儿(N=662;281 名女孩,381 名男孩;年龄 3-14 岁)。

干预措施

不适用。

主要观察指标

智力测试采用韦氏学前和小学智力量表和韦氏儿童智力量表修订版进行。粗大运动功能水平由粗大运动功能分类系统扩展和修订版(GMFCS E&R)确定。

结果

在这些儿童中,10.4%处于 GMFCS E&R 的 I 级,38%处于 II 级和 III 级,51.5%处于 IV 级和 V 级。痉挛性四肢瘫痪的儿童(n=28,62.2%)智力水平最低或存在严重智力障碍。与 V 级儿童相比,处于最低水平(I-IV,GMFCS E&R)的儿童在智力方面获得了更高的评分。根据目前的结果,诊断与智力水平作为因变量具有统计学相关性(P<.01);因此,低张型、四肢瘫痪型和偏瘫型患者分别具有更高的可能性被评定为智力异常。性别和年龄与因变量无统计学相关性。

结论

研究结果表明 GMFCS E&R 与智力功能之间存在显著关联。因此,我们建议在评估粗大运动功能时应特别注意智力水平。这些结果可能会引起参与这些儿童康复计划的职业治疗师和物理治疗师的兴趣。

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