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自闭症谱系障碍中运动差异的系统评价和荟萃分析综述、基于运动的干预措施的效果及潜在神经机制的荟萃元分析

Meta review of systematic and meta analytic reviews on movement differences, effect of movement based interventions, and the underlying neural mechanisms in autism spectrum disorder.

机构信息

Movement Development Clinic, School of Physical Education, University of Otago Dunedin, New Zealand.

出版信息

Front Integr Neurosci. 2013 Mar 26;7:16. doi: 10.3389/fnint.2013.00016. eCollection 2013.

Abstract

PURPOSES

To identify and appraise evidence from published systematic and meta analytic reviews on (1) movement differences of individuals with autism spectrum disorders (ASD); (2) the effects of movement based interventions for ASD; (3) hypothesized underlying neural mechanisms for the movement characteristics.

METHODS

A meta review of published systematic and meta analytic reviews on movement differences, structural, and functional brain anomalies in ASD and the effects of movement based interventions for individuals with ASD between 1806 and October 2012. The methodological quality of the identified systematic and meta analytic reviews was independently assessed by two assessors with the assessment of multiple systematic reviews (AMSTAR).

RESULTS

The search yielded a total of 12 reviews that met the inclusion/exclusion criteria. The methodological quality of the reviews varied, but the review conclusions were similar. Although individuals with ASD generally perform less well than age-matched controls in developmental movement tasks, there are few exceptions whose movement abilities are intact. Most movement based interventions report their efficacies. However, all existing studies employ the research design that is inherently incapable of providing strong evidence, and they often fail to report the extent of psychosocial interactions within the movement interventions. The hypothesized neural mechanisms are still under development and speculative in nature.

CONCLUSIONS

It is premature to designate movement disturbance as a core symptom of ASD. The effects of movement based interventions on the present ASD core symptoms need to be further validated by stronger evidence and verified theoretical mechanisms linking ASD with movement disorders.

摘要

目的

识别和评价已发表的系统评价和荟萃分析文献中的证据,内容涉及(1)自闭症谱系障碍(ASD)个体的运动差异;(2)基于运动的 ASD 干预措施的效果;(3)运动特征的假设潜在神经机制。

方法

对 2012 年 10 月之前发表的关于 ASD 中运动差异、结构和功能脑异常以及基于运动的 ASD 个体干预措施效果的系统评价和荟萃分析文献进行元综述。两名评估人员使用评估多项系统评价(AMSTAR)独立评估确定的系统评价和荟萃分析的方法学质量。

结果

搜索共产生了 12 篇符合纳入/排除标准的综述。这些综述的方法学质量各不相同,但综述结论相似。尽管 ASD 个体在发展性运动任务中的表现通常不如年龄匹配的对照组,但也有少数人的运动能力完好无损。大多数基于运动的干预措施都报告了其疗效。然而,所有现有的研究都采用了本质上无法提供有力证据的研究设计,并且经常未能报告运动干预措施中社会心理互动的程度。假设的神经机制仍在发展中,具有推测性。

结论

将运动障碍指定为 ASD 的核心症状还为时过早。需要通过更强有力的证据和验证将 ASD 与运动障碍联系起来的理论机制来进一步验证基于运动的干预措施对当前 ASD 核心症状的效果。

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