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目前治疗师在测量脑瘫及其他神经疾病患儿的躯体感觉时采用的是什么方法?

What is the current practice of therapists in the measurement of somatosensation in children with cerebral palsy and other neurological disorders?

作者信息

Walmsley Corrin, Taylor Susan, Parkins Timothy, Carey Leeanne, Girdler Sonya, Elliott Catherine

机构信息

School of Occupational Therapy and Social Work, Curtin University, Perth, Australia.

Department of Paediatric Rehabilitation, Princess Margaret Hospital for Children, Perth, Australia.

出版信息

Aust Occup Ther J. 2018 Apr;65(2):89-97. doi: 10.1111/1440-1630.12431. Epub 2017 Dec 28.

Abstract

BACKGROUND/AIM: Somatosensation is the ability to detect and recognise body sensations such as touch, vibration, pressure, pain, temperature and proprioception. Cerebral palsy is a neurological disorder that is often accompanied by impairments in somatosensation. Current somatosensory assessments have limited psychometrics established for use with these children. The aim of this study was to identify therapists' current practice and perspectives related to the assessment of somatosensation in children with neurological disorders.

METHODS

A cross-sectional questionnaire was used to identify the somatosensory assessments currently used in clinical practice, time allocated to assessment, and therapists' satisfaction and confidence using the available assessments of somatosensation. The questionnaire was adapted from a previously utilised questionnaire that identified therapists' use of somatosensory assessments with adults post-stroke.

RESULTS

A total of 135 therapists responded to the questionnaire. Seventy-nine (92%) occupational therapists and 44 (89.7%) physiotherapists indicated that they currently assessed or treated children with somatosensory deficits. Sixty-four (82.1%) occupational therapists and 38 (86.3%) physiotherapists regarded assessment of somatosensation in children with neurological disorders as important to very important. However, only seven (8.8%) occupational therapists and seven (15.9%) physiotherapists reported confidence in their ability to do so. The methods with which therapists detect and measure somatosensory impairment in children with neurological disorders are variable, with non-standardised and/or informal assessments most frequently used.

CONCLUSION

Despite there being recommendations of best practice for the assessment of specific domains of somatosensation in children with cerebral palsy, current practice does not yet mirror these recommendations. Additionally, therapists have low satisfaction and confidence with what they are currently using, highlighting the need for a comprehensive and standardised assessment of somatosensation for use in children with neurological disorders.

摘要

背景/目的:躯体感觉是指检测和识别诸如触觉、振动觉、压力觉、痛觉、温度觉和本体感觉等身体感觉的能力。脑瘫是一种神经障碍,常伴有躯体感觉受损。目前的躯体感觉评估针对这些儿童所建立的心理测量学指标有限。本研究的目的是确定治疗师目前在评估神经障碍儿童躯体感觉方面的实践和观点。

方法

采用横断面问卷调查法,以确定目前临床实践中使用的躯体感觉评估方法、分配给评估的时间,以及治疗师对现有躯体感觉评估方法的满意度和信心。该问卷改编自之前用于确定治疗师对中风后成人躯体感觉评估使用情况的问卷。

结果

共有135名治疗师回复了问卷。79名(92%)职业治疗师和44名(89.7%)物理治疗师表示,他们目前评估或治疗有躯体感觉缺陷的儿童。64名(82.1%)职业治疗师和38名(86.3%)物理治疗师认为对神经障碍儿童的躯体感觉评估非常重要。然而,只有7名(8.8%)职业治疗师和7名(15.9%)物理治疗师报告对自己进行此项评估的能力有信心。治疗师检测和测量神经障碍儿童躯体感觉障碍的方法各不相同,最常使用的是非标准化和/或非正式评估。

结论

尽管已有针对脑瘫儿童特定躯体感觉领域评估的最佳实践建议,但目前的实践尚未反映这些建议。此外,治疗师对他们目前使用的方法满意度和信心较低,这凸显了对神经障碍儿童进行全面和标准化躯体感觉评估的必要性。

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