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自闭症谱系障碍儿童体感治疗后疼痛敏感性降低。

Reduction of Pain Sensitivity after Somatosensory Therapy in Children with Autism Spectrum Disorders.

机构信息

University Institute of Health Sciences Research (IUNICS-IdISPa), University of the Balearic Islands, Palma de Mallorca, Spain.

Department of Nursing and Physiotherapy, University of the Balearic Islands, Carretera de Valldemossa km 7.5, 07122, Palma de Mallorca, Spain.

出版信息

J Abnorm Child Psychol. 2018 Nov;46(8):1731-1740. doi: 10.1007/s10802-017-0390-6.

Abstract

Children with autism spectrum disorders (ASD) often present with somatosensory dysfunction including an abnormal reactivity to tactile stimuli and altered pain perception. A therapy based on somatosensory stimuli has shown effectiveness in reducing pain sensitivity among adults with cerebral palsy. The present study aims at exploring the influence of somatosensory therapy on somatosensory parameters in children with ASD. Children with high-functioning ASD were randomly assigned to either the intervention (n = 29) or the control group (n = 30). The intervention group received a somatosensory therapy consisting of four types of exercises (touch, proprioception, vibration, stereognosis). Somatosensory function (pressure pain thresholds, tactile thresholds, stereognosis, proprioception) was assessed before and immediately after the therapy. Children in the intervention group showed a significant reduction of pain sensitivity and increase of tactile sensitivity after treatment, whereas children in the control group displayed increased pain sensitivity in the absence of changes of tactile sensitivity. No changes were observed for proprioception or stereognosis. The repetitive somatosensory stimulation therapy led to a decrease of pain sensitivity and an increase of tactile sensitivity. These findings may have important research and clinical implications, as promoting early tactile interventions in children with ASD may lead to a more adequate development of somatosensory processing and less somatosensory abnormalities upon adult life.

摘要

患有自闭症谱系障碍(ASD)的儿童通常存在躯体感觉功能障碍,包括对触觉刺激的异常反应和改变的疼痛感知。基于躯体感觉刺激的治疗已显示出在脑瘫成年患者中降低疼痛敏感性的有效性。本研究旨在探讨躯体感觉治疗对 ASD 儿童躯体感觉参数的影响。高功能 ASD 儿童被随机分配到干预组(n=29)或对照组(n=30)。干预组接受了四种类型的练习(触摸、本体感觉、振动、触觉辨别)组成的躯体感觉治疗。在治疗前后评估了躯体感觉功能(压痛阈值、触觉阈值、触觉辨别、本体感觉)。干预组儿童在治疗后疼痛敏感性显著降低,触觉敏感性增加,而对照组儿童在没有触觉敏感性变化的情况下疼痛敏感性增加。本体感觉或触觉辨别没有变化。重复的躯体感觉刺激治疗导致疼痛敏感性降低和触觉敏感性增加。这些发现可能具有重要的研究和临床意义,因为在 ASD 儿童中早期进行触觉干预可能会导致躯体感觉加工的更充分发展,并且在成年后出现较少的躯体感觉异常。

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