脑瘫儿童参与体育活动：基于处方的体育活动的可行性与有效性
Participation in physical activities for children with cerebral palsy: feasibility and effectiveness of physical activity on prescription.
作者信息
Lauruschkus Katarina, Hallström Inger, Westbom Lena, Tornberg Åsa, Nordmark Eva
机构信息
Department of Health Sciences, Faculty of Medicine, Lund University, Box 157, -221 00 Lund, SE Sweden.
Department of Clinical Sciences Lund, Division of Paediatrics, Lund University, Lund, Sweden.
出版信息
Arch Physiother. 2017 Nov 28;7:13. doi: 10.1186/s40945-017-0041-9. eCollection 2017.
BACKGROUND
Children with cerebral palsy (CP) are less physically active and more sedentary than other children which implies risk factors for their physical and mental health. Physical activity on prescription (PAP) is an effective intervention to promote a lifestyle change towards increased physical activity in adults in general. Knowledge is lacking about the use of PAP in children with CP. Therefore, the aim of this study was to evaluate the feasibility of PAP for children with CP and its effectiveness on participation in physical activity and sedentary behaviour.
METHODS
Eleven children with CP, aged 7-11 years, participated in PAP, consisting of a written agreement between each child, their parents and the physiotherapist and based on Motivational Interviewing (MI), Canadian Occupational Performance Measure (COPM) and Goal Attainment Scaling (GAS). Individual goals, gross motor function and physical activity were assessed at baseline, at 8 and/or 11 months using COPM, GAS, logbooks, Gross Motor Function Measure (GMFM-66), physical activity questionnaires, physical activity and heart rate monitors and time-use diaries. At 8 and 11 months the feasibility of the intervention and costs and time spent for the families and the physiotherapist were evaluated by questionnaires.
RESULTS
The intervention was feasible according to the feasibility questionnaire. Each child participated in 1-3 self-selected physical activities during 3-6 months with support from the physiotherapist, and clinically meaningful increases from baseline of COPM and GAS scores were recorded. Being physically active at moderate-vigorous levels varied between less than 30 and more than 240 minutes/day, and the median for the whole group was 84 minutes/day at baseline and 106 minutes/day at 8 months.
CONCLUSIONS
The intervention PAP seems to be feasible and effective for children with CP, involving both every day and organised physical activities to promote an active lifestyle through increased participation, motivation, and engagement in physical activities. Further research of PAP is needed, preferably in a long term randomised controlled trial and including health economic analysis to show costs and benefits.
TRIAL REGISTRATION
ISRCTN76366356, retrospectively registered.
背景
与其他儿童相比，脑瘫（CP）患儿身体活动较少，久坐时间更长，这意味着存在影响其身心健康的风险因素。一般而言，运动处方（PAP）是促进成年人生活方式转变以增加身体活动的有效干预措施。目前尚缺乏关于在CP患儿中使用PAP的相关知识。因此，本研究的目的是评估PAP对CP患儿的可行性及其对参与身体活动和久坐行为的有效性。
方法
11名7至11岁的CP患儿参与了PAP，该方案包括每个患儿、其父母与物理治疗师之间的书面协议，并基于动机性访谈（MI）、加拿大职业表现测量（COPM）和目标达成量表（GAS）制定。在基线、8个月和/或11个月时，使用COPM、GAS、日志、粗大运动功能测量（GMFM - 66）、身体活动问卷、身体活动和心率监测器以及时间使用日记评估个体目标、粗大运动功能和身体活动情况。在8个月和11个月时，通过问卷调查评估干预措施的可行性以及家庭和物理治疗师所花费的成本和时间。
结果
根据可行性调查问卷，该干预措施是可行的。在物理治疗师的支持下，每个患儿在3至6个月内参与了1 - 3项自选的身体活动，并且记录到COPM和GAS评分较基线有临床意义的增加。中等至剧烈强度的身体活动时间每天在不到30分钟至超过240分钟之间变化，整个组的中位数在基线时为每天84分钟，在8个月时为每天106分钟。
结论
运动处方干预措施对CP患儿似乎是可行且有效的，包括日常和有组织的身体活动，通过增加参与度、动机和对身体活动的投入来促进积极的生活方式。需要对PAP进行进一步研究，最好是进行长期随机对照试验，并包括健康经济分析以显示成本和效益。
试验注册
ISRCTN76366356，追溯注册。
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